Research examines challenges in publishing reliable provider directories

Doctor workplace in office

Research examines challenges in publishing reliable provider directories

To sum up the research, health plans should now be taking a proactive role in achieving and maintaining provider directory accuracy, even if they have to overcome operational challenges to do so.

“Given an environment that is increasingly regulatory, litigious, investigative, and putative, health plans should deploy organizational resources at a level that is commensurate with the level of risk that these inaccuracies can present,”Brian Hoyt, Managing Director at BRG, told RevCycleIntelligence.

CMS has warned that it may issue penalties and enrollment sanctions against health plans with inaccurate or deficient directories, and has already levied a million dollar fine against Aetna for inaccuracies in provider information disseminated through one of its call centers, according to Hoyt.
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