Provider Demographic Changes

It is important for Vivida to keep its provider network information up-to-date. Up-to-date provider information allows Vivida to accurately generate provider directories, process claims and communicate with its network of providers.

Providers must notify Vivida in writing at least 60 days in advance when possible of changes, such as:

• Change in practice ownership or Federal TAX ID number
• Practice name change
• A change in practice address, phone or fax numbers
• Change in practice office hours
• New office site location
• Primary Care Providers (PCP) only: If your practice is open or closed to new patients

The provider data change form can be found at Forms and Claims page

Send changes via:

Email:  providerrelations@vividahealth.com.

Fax: 1-888-396-1226

Mail:

Vivida Health
C/O Provider Services
6630 Orion Dr.
Fort Myers, FL 33912

For additional assistance, contact provider services at 1-844-243-5175.