Update Your Information
Please let us know of any changes to your practice information such as:
- Addition or deletion of an associated physician or associated provider.
- Addition of a new office location or the elimination of an existing office location.
- Change in office location or office hours policy regarding weekend or evening hours.
- Change in the tax identification number, or practice or physician billing number.
- Decision to stop accepting new members in any program.
- Sale or closure of your practice.
Please consult your participating provider agreement for your specific responsibilities and time frames for notice. These changes should be mailed to the Provider Service Telephone Unit at:
Provider Service Telephone Unit
PO Box 779519
Harrisburg, PA 17177
For your convenience, we have provided a Provider Change Notification Form. When we receive notice of the changes, a letter of confirmation will be sent to you from us to officially document your changes.
If you have any questions, please call the Provider Services Telephone Unit at 1.866.688.2242