Managing Providers

We're updating the system to use Provider ID as the unique identifier for providers, replacing provider name and address. Whenever possible, we recommend using the provider’s NPI; if that’s not available, you may use any number that uniquely identifies the provider within your organization or your client’s.

This change aligns with industry standards and supports future enhancements in Audit Manager+, such as comparing billing and performance across providers and integrating CMS data for deeper insights. Using NPI as the Provider ID is strongly encouraged to maximize these benefits.

Starting on the effective date, Provider ID will be required when adding or uploading providers. If it’s missing, manual entry or bulk upload will fail. We recommend including Provider ID in your processes now to avoid disruptions.

After this change goes live, any edits to existing providers without a Provider ID will prompt you to add one before saving.
Note: For claim bulk imports, the provider name can still be used if a Provider ID isn’t available.

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