New 90-day Demographic Verification Requirement
New 90-day demographic verification requirement
Last update Feb. 8, 2022
Beginning Jan. 1, 2022, health care professionals who are contracted with UnitedHealthcare are required to verify the accuracy of their demographic information every 90 days. This is a change from the previous 120-day verification schedule.
This means that anyone who last reviewed and verified demographic data in early October 2021 will now be due to review their information in early January 2022 (90 days), instead of early February 2022 (120 days).
Why verifying your data is important
Keeping your practice information up-to-date in our provider directories is one of the best ways to help ensure our members can find you.
And, for health care professionals who see members covered by an Individual Exchange or Individual and Group Market (commercial) health plan, you’re required to follow this new timeline to meet requirements of the Consolidated Appropriations Act of 2021. Consistent with the Consolidated Appropriations Act, we may remove health care professionals from the network directory if we have been unable to verify information.
How to verify your data
There are 4 methods to verify and submit any new demographic information. In most cases, you’ll be notified when it’s time to review your demographic information, based on how you’ve previously verified your data. Please respond by the deadline listed to help ensure you remain in our network directories.
CAQH is a multi-payer solution that allows you to update your profile in real time and have instant access to directory services and more.
90-day review notification: You’ll receive an email from CAQH.
2.Roster Management program
If you’re a contracted health care professional in the Roster Management program, please work directly with your assigned roster manager to review and verify the accuracy of your practice’s data.
90-day review notification: Your UnitedHealthcare roster manager typically notifies you.
3.My Practice Profile
My Practice Profile lets you verify and attest to the accuracy of your practice’s data. UnitedHealthcare shares this information with members to locate your organization.
90-day review notification: You’ll receive an email from UnitedHealthcare.
If you don’t have access to the other methods, you can verify your practice data using the UnitedHealthcare demographic change request form.
90-day review notification: You are responsible for tracking the 90-day cycle and submitting an updated form.
What information to review
- As you review your practice data for accuracy, be sure to:
- Inform us of changes to your practice name, ownership or control
- List changes to your National Provider Identifier (NPI) or tax identification number (TIN)
- Confirm all service and billing addresses you’re listed under, including adding the suite or building number
- Ensure that only addresses where members can regularly schedule an appointment are marked for directory display
- Confirm the phone number members can use to schedule an appointment
- Validate that your specialty is listed and accurately credentialed in our system
- Inform us of education and/or certification updates
- List the most current and appropriate email address and website URL