Provider Maintenance
Updating Provider Demographic Information
Having access to accurate provider information is vitally important to SilverSummit members. To ensure a member’s health is not compromised, providers are required to have their contact and demographic information up-to-date. Providers should notify SilverSummit of any changes (ex. address or telephone number updates), if they can no longer accept new patients or are leaving the network.
For the requests listed below, please complete this PDQ Request FormExternal Link:
- Add Practitioner(s) to a Contracted group
- requests must include a completed Practitioner Data Form(PDF)
- If adding 30 or more individual practitioners, please reach out to NVSS_Providerquality@silversummithealthplan.com for a Blank Credentialing Roster
- Removing Practitioner(s) from a Contracted group
- Panel Updates
- Other demographic updates that cannot be updated through the SilverSummit Provider PortalExternal Link
**Please ensure the following information is complete to avoid any delays or returns:**
- The Practitioner Data Form (PDF) is completed in its entirety
- CAQH was Attested within the last 6 months and that SilverSummit has access.
- Taxonomy Specialty included matches NPPES and License
All requests will be worked in the order they are received. An email notification will be sent confirming that your request has been received with a reference ID at the bottom of the email. An email notification will also be sent once a ticket has been submitted and once the request has been completed.
For faster service, providers can update the following information through the SilverSummit Provider PortalExternal Link:
- Phone number updates
- Location updates
Additional Resources
*If you are inquiring about claims issues or projects, please access the Provider Claims Tools or reach out to your Provider Relations Representative.
You can send an email to NVSS_ProviderRelations@silversummithealthplan.com
*For Provider Demographic related inquiries not outlined above please send an email to nvss_providerquality@silversummithealthplan.com
SilverSummit is continuing to streamline our process. This following functions will be available soon. If you need to report a change, continue to use the PDQ request form above.
Demographic Change
- Change Phone Number
- Change Practitioner Name
- Add/Remove a Language Spoken
- Update Practitioner Office Hours
- Update Service Location Office Hours
- Update Speciality
- Practitioner Race/Ethnicty
- Change Accepting New Members Status
- Change Panel Size (PCP Only)
- Change Age Restrictions
Terms
Enrollments
- Enroll a new provider to a contracted group
- Enroll a multiple providers to a contracted group