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Network Operations

Directory Updates

CMS routinely audits Medicare Advantage (MA) online provider directories. CMS issues compliance notices to health plans if it determines the plan’s provider directory is inaccurate.

A person who enrolls in a health insurance plan relies on these online directories to access care. When the information is incorrect, it can create a barrier to members getting the healthcare they need.

Premier Health Plan’s provider directories must be updated every 30 calendar days, or the Health Plan can be sanctioned by CMS. Practices must provide accurate office location, phone number(s) and hours of operation data to PHG. It’s important to notify us when this information changes. Please communicate all provider changes (i.e. new providers, terminations, office changes, accepting new patients/not accepting new patients, etc.) to the PHG team using the Provider/Change of Address/Deletion Form. Please email the completed form to PHG@PremierHealth.com or fax to (937) 641-7377(937) 641-7377.

Medical Pay Policies

Throughout the year, we update our Medicare Advantage and Commercial Policies and Procedures. Go here to view the most recent policies and procedures:

Back to the December 2017 Issue