Provider Information for Authorizations (PIA)

Please note: 

For updates to in-network/participating providers with Michigan, Louisiana, Kansas, Arkansas & Walmart:   

·         If you're speaking with the provider, please instruct them to update their information directly with the plan, either via the plan website or contacting their plan provider representative as appropriate.

·         If you’re speaking with a member, please report using Datix.  


For updates to in-network/participating providers contracted with NDBH (Alabama, Florida, Kansas City, and Arkansas FEP):

·         Use the Incorrect Provider Data Found form here:

For updates and adds for out-of-network/non-participating or BlueCard providers
, please continue use of this form.

NDBH employee email, if applicable
Facility Group Information

Individual Information
Address Location