Under pressure from federal and state regulators to make better the timeliness and accuracy of contributor directories, health insurers are observing to software vendors for answers.
Working with the payer trade group America’s Health Insurance Plans, 12 insurers will conduct 6-month pilot programs in California, Florida and Indiana, starting in April. The insurers will work with healthcare transaction processing vendors Availity and BetterDoctor to validate and update data on physicians, then update the insurers’ provider directories.
These directories have been notoriously inaccurate for many years, making it complex for sufferers seeking a latest or different doctor to get correct data. Sufferers often choose a physician practice that is listed as accepting new patients, but is not. Or, patients will select a physician listed as being in the patient’s network, but the practice is really out of network.
That is why regulators are seeking improvements in the procedure. The Centers for Medicare and Medicaid Services, for instance, needs insurers to update their provider directories every ninety days.
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