Availity Essentials Searches Require Identifiers

Starting June 2026, you must enter a National Provider Identifier (NPI) when you check eligibility or claim status in Availity Essentials.

Why it Matters

The Centers for Medicare & Medicaid Services (CMS) require NPIs on eligibility and claim status transactions under the Health Insurance Portability and Accountability Act (HIPAA). This change helps keep searches accurate and compliant.

What’s Changing

Before, you could run these searches using only a Tax Identification Number (TIN). The NPI field was optional. An NPI is required for eligibility and benefits searches, and claim status searches. If you do not enter an NPI, your search may not return results.

What to Do

To avoid delays, enter the correct NPI when you search in Availity Essentials. Make sure the NPI is active and matches the billing or servicing provider.