OSP News

Priority Health is Reminding You To Be Sure to Keep Your Practice Name Updated in Their Find a Doctor Tool

Posted: 08/04/2023

To keep the Priority Health Find a Doctor tool accurate and to meet their requirements as a health plan, they may remove providers who don’t maintain their information with Priority Health.

This means you may be removed from Find a Doctor if your practice name doesn’t match the name you answer your phone with or if your other data, like locations or hours of operation, are not accurate.

For example, if you answer the phone as “ABC Family Medicine” your name in Find a Doctor should be “ABC Family Medicine.”

Why is this important?
With an accurate directory, Priority Health can:

  • Improve the quality of provider data in our directories to help members—and prospective patients for you—find the care they need.
  • Ensure compliance with provider directory regulatory bodies The Centers for Medicare and Medicaid Services (CMS) requires us to keep this information up to date.

How to update your practice name
To notify them of a name change, follow these steps 60 days or more before the change takes effect:

  • Log in to your prism account.
  • Click on Enrollments & Changes.
  • Select either Change Individual Provider or Change Provider Organization.
  • Follow the directions as indicated. For individual requests, submit a Provider Change Form. For multiple requests, submit a Provider Change Template.

The form must contain:

  • What's changing.
  • The effective date of the change.
  • Entity or tax ID number (EIN or TIN) W-9, as applicable.
  • NPI number and taxonomy designation (specialty type) that you'll be using for billing.
  • If your request is to change the group information for a provider group, include the Type 1 NPIs of the impacted practitioners.

Although this reminder is sent out by Priority Health it is equally as important to keep your practice information current with OSP. If you have any questions, please feel free to call (248)357-4048.


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