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Update Info

Information Change

Federal law requires provider directory information to be reviewed and verified at least every 90 days. To ensure prompt and accurate claims processing and an accurate provider list for our patients and payers, we ask that you update your information regularly by completing this form to notify MedCost of any changes prior to the effective date of the change.

Main contact

Practice or facility information

Credentialing information

Tax ID change
Address change - Old address
Old address
Address change - New Address
New address
Name change
Phone change
Specialty Change
(Includes moving practice to telehealth)
Add to directory
Other changes