Last modified: December 10, 2020
Your commercial contract with us obliges you to notify us of any change in Medical Professionals, including nonphysician professionals such as nurse practitioners, clinical nurse specialists and physician assistants.
Failure to do so may result in denial of claims or incorrect payment.
What you need to do
This obligation is met when an updated roster is submitted in writing, electronically in
All data elements must be provided* in order for a roster to be considered a “clean” roster.
If any data element is not applicable to your staff member, indicate “not applicable” in the appropriate field.
As outlined in your contract, the required data elements are:
Questions? Please contact your network management team or provider relations representative.