Moving your office? Adding a location? PacifiCare Behavioral Health requests that network providers notify the Provider Network Management Department of changes within their practice. Practice changes include:
Change of office address or phone number
Addition or deletion of an office location
Change of mailing address
Change of emergency phone or pager numbers
Change of tax ID number or check payable name
Change of NPI or Taxonomy Code
To make a change for one of these reasons, providers must complete the Change of Address/ Information form on the next page and fax it to the listed number.
As part of our commitment to quality customer service, PBH requests that providers assist us in maintaining the current status of their practice.
Status changes to notify PBH Provider Network Management about:
Maternity leave
Extended vacations/illnesses
Restrictions in referrals (e.g. not accepting new members)
Availability (e.g. evening, weekend)
Status changes can be made by calling the PBH Provider Helpline at (800) 716-1166.
