Administrative Forms

Billing and Claims Forms

Provider Demographic Updates/Change of Address Forms

  • Are you receiving important communications from Beacon Health Options?
  • Are members able to reach you for referral purposes?
  • Are manual processes like faxing paperwork and filling out forms by hand taking hours out of your day?

In just a few steps, network providers can submit real time demographic updates electronically via ProviderConnect. Electronically submit demographic updates today or you may fail to receive an important communication or referral opportunity.

Beacon strongly recommends providers update their demographic information using ProviderConnect. To update active service locations, addresses, phone numbers, billing locations and other contact information, log into ProviderConnect and click on the “Update Demographic Information” link. Learn more by viewing Section 20 of the ProviderConnect User Guide.

If you have questions about a demographic update, please contact the National Provider Service Line at 800.397.1630 Monday through Friday, between 8:00 a.m. and 8:00 p.m. ET.

Provider Notification Forms


ProviderConnect Forms

Please visit the Forms section of our ProviderConnect page to access forms and other ProviderConnect resources.

Member Forms

Site Review Forms

eServices Forms