Medicare AdvantageMedicaidMedicare-Medicaid PlanJuly 1, 2024
Availity PDM application is now intake channel for all demographic change requests
The Provider Data Management (PDM) application on Availity Essentials is now the only intake application to verify and initiate care provider demographic change requests for all professional and facility care providers.** This new process includes submitting roster uploads.
The Provider Demographic Change Form has been retired.
Training is available:
- PDM application-specific trainings:
- Learn about and attend one of our training opportunities by visiting here.
- View the Availity PDM quick start guide here.
- Roster Automation Standard Template and Roster Automation Rules of Engagement-specific training:
- Listen to our recorded webinar here.
Note: An Availity account is required to access these training options. If not registered, see below for registration instructions and details.
Choice and flexibility to select the option that works best for you
Request data updates via either of the following options:
- Standard PDM experience
- Submitting a spreadsheet via a roster upload
Benefits to our care providers using Availity PDM
The Availity PDM application will ensure the following:
- Consistently updated data
- Decreased turnaround time for updates
- Compliance with federal and/or state mandates
- Improved data quality through standardization
- Increased care provider directory accuracy
Want to submit a roster using Availity PDM?
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. Most care providers, whether an individual care provider/practitioner, group, or facility, can use Roster Automation.
Use the Roster Submission template and guide
Find them online: On Availity.com > Payer Spaces > Select Payer Tile > Resources > Roster automation Standard Template and Roster Submission Guide using Provider Data Management.
Availity PDM compatibility check for roster submissions
Availity PDM has been enhanced to incorporate a roster compatibility check. Care providers can see if the roster was successfully submitted:
- If there is an error to the roster, care providers will see an error rejection message with detailed reason for the rejection.
- Errors will need to be corrected. Then, the roster should be re-uploaded. Status will show as successfully submitted once corrected and re-submitted.
- After successful submission of the roster, all accepted elements of the roster will be processed and only errors/rejections will fall out.
- Any elements that fall out will require manual intervention.
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 an administrator. To find your administrator, go to My Account Dashboard > My Account > Organization(s) > Administrator Information.
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 care 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 more than one TIN, please ensure you have registered all TINs associated with your Availity account.
If you have questions regarding registration, reach out to Availity Client Services at 800‑282-4548.
** Exclusions:
- Behavioral health care 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 care provider demographic updates.
- Change tax ID.
- Change organization name.
- Add a network to agreement.
- Change care provider specialty.
- Terminate entire agreement.
If you require any further assistance or have questions regarding this update, contact a care provider relationship management representative by completing a Contact Us webform inquiry at https://provider.wellpoint.com/texas-provider/contact-us/email.
Carelon Behavioral Health, Inc. is an independent company providing utilization management services on behalf of the health plan.
Medicaid coverage provided by Wellpoint Insurance Company to members in the Medicaid Rural Service Area and the STAR Kids program and Wellpoint Texas, Inc. to all other Wellpoint members in Texas.
Medicare coverage provided by Wellpoint Texas, Inc. or Wellpoint Insurance Company.
Medicare-Medicaid Plan coverage provided by Wellpoint Texas, Inc.
TXWP-CDCRMMP-057092-24
PUBLICATIONS: July 2024 Provider Newsletter
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