Demographic information updates are a big deal. When you file an insurance claim, the HCFA form lists your name and title, business name, practice and billing addresses, tax ID, and NPI. Insurance companies use these data to verify your identity and prevent fraud. It should be current and correct.
What Happens if I Update my Demographic Information?
If possible, avoid updating your demographic information. It’s messy.
But if you need to move, change your billing address, or update your business name, tax ID, or NPI number, plan carefully. Failure to notify insurance companies (and your biller!) in advance is one of the biggest mistakes a provider can make.
Here’s a short list of things that can go wrong:
- Rejected claims
- Delays in claims processing and payment
- Claims processing as out of network
- Incorrect 1099 information at the end of the year
- Inaccurate benefit information
- Checks may be sent to the wrong address
When Should I Update my Demographic Information?
Ideally, you should notify insurance carriers at least 60-90 days before updates take place. Read your network contracts carefully regarding demographic updates.
Each insurance company requires a different processing time to update their system. Some companies take only 7-10 business days; others take up to 3 months.
Can I Backdate my Effective Date?
Manage your expectations and prepare to be disappointed. Some companies may allow you to backdate the effective date, but most won’t. Even if the carrier is willing to backdate, there’s no guarantee that claims will go smoothly.
To avoid billing trouble, let us know right away when making changes to your practice.
Need a Hand?
Our sister company Alchemy Credentialing offers complete demographic information update assistance for your practice.
Accurate, affordable, and timely, Alchemy’s services include:
- Notification of all contracted carriers, and those currently being billed
- Completion of necessary forms and request letters
- Faxing, filing, and emailing forms according to carrier procedures
- Email correspondence for questions, troubleshooting, advice, and more!
Life is change. Stay ahead of the game! Begin planning your updates as early as possible to ensure a smooth transition.
For pricing and further details, contact Alchemy Credentialing today.