PDM capability now available on Availity Essentials — retirement of previous intake channels January 1, 2024

As we continue our path to be your most valued partner in the industry, we will use the Provider Data Management (PDM) application on Availity Essentials* to verify and initiate care provider demographic change requests for all professional and facility care providers.** Going forward, Availity Essentials PDM is now the intake application for care providers to submit demographic change requests, including submitting roster uploads. Availity PDM will replace all current intake channels for demographic change requests and roster submissions as of January 1, 2024. New group/professional contract requests and provider additions to an existing group/professional contract must be submitted through Provider Enrollment application in Availity Essentials.

Benefits to our care providers using Availity PDM:

The Availity PDM application will ensure the following:

• Attest and manage current provider demographic information.
• Consistently updated data
• Decreased turnaround time for updates
• Compliance with federal and/or state mandates
• Improved data quality through standardization
• Increased provider directory accuracy

Choice and flexibility to select the option that works best for you:

Request data updates via either of the following options within Availity PDM:

• Multi-payer platform option: Allows providers to make updates once and have that information sent to all participating health plans, submitting each change separately.
• Roster Upload option: Allows providers to submit multiple updates within one spreadsheet via the Upload Rosters feature:
  • Upload Roster feature is currently only available and shared with Anthem.

Want to submit a roster using Availity PDM?

Now you can. Roster Automation is our new technology solution designed to streamline and automate provider data additions, changes, and terminations that are submitted using a standardized Microsoft Excel submission. Any provider, whether an individual provider/practitioner, group, or facility, can use Roster Automation today:***

1. Utilize the Roster Automation Standard Template:

• For your convenience, there is a standard roster Excel document. Find it online here.

2. Follow the Roster Automation Rules of Engagement:

• This reference document is available to ensure error-free submissions, driving accurate and more timely updates through automation. Find it online here.
• More detailed instructions on formatting and submission requirements can also be found on the first tab of the Roster Automation Standard Template (User Reference Guide).

3. Upload your completed roster via the Availity PDM application.

What about the previous methods by which I have been submitting information?

While we are in the process of sunsetting our legacy intake channels, we will continue to process submissions received through current intake channels until December 31, 2023. Effective January 1, 2024, all PDM requests, including rosters, must be submitted via Availity PDM. As of this date, all provider demographic change requests, including rosters, will be rejected if submitted through any format/channel other than Availity PDM. New group/professional contract requests and provider additions to an existing group/professional contract must be submitted through Provider Enrollment application in Availity Essentials.

How to access the Availity PDM application

Log on to Availity.com and select My Providers > Provider Data Management to begin the attestation process. If submitting a roster, find the TIN/business name for which you want to verify and update information. Before you select the TIN/business name, select the three-bar menu option on the right side of the window, and select Upload Rosters (see screen shot below) and follow the prompts.

Availity administrators will automatically be granted access to PDM. Additional staff may be given access to Provider Data Management by your Availity administrator. To find your Availity administrator, go to My Account Dashboard > My Account > Organization(s) > Administrator Information.

Training is available:

• Availity PDM application specific training: (Availity account is required for accessing these training options. If not registered yet, see end of article for registration details.)
  • Learn about and attend one of our live webinars by visiting here. (Note: You must log into Availity first, then select the link.)
  • View the Availity PDM quick start guide here. (Note: You must log into Availity first, then select the link.)

Not registered for Availity yet?

If you aren’t registered to use Availity Essentials, signing up is easy and 100% secure. There is no cost for your providers to register or to use any of our digital applications. Start by going to Availity.com and selecting New to Availity? Get Started at the top of the home screen to access the registration page.

If you have questions regarding registration, reach out to Availity Client Services at 800‑AVAILITY.

Start using Availity PDM today to improve your provider data management experience.

As a reminder, providers are responsible for the accuracy of the data they submit as well as submitting updates timely. If submitted updates or untimely updates result in claim denials or rejections, denials will stand.

** Exclusions:

• Behavioral Health providers assigned to Carelon Behavioral Health, Inc.* will continue to follow the process for demographic requests and/or roster submissions, as outlined by Carelon Behavioral Health.
• Any specific state mandates or requirements for provider demographic updates.

*** If any record requires credentialing, that record will be rejected, and must follow the Provider Enrollment application process.