Support From Both Sides: AHIP Uncovers Lessons And Best Practices For Keeping Provider Directories Up To Date

by Kristine Grow

March 9, 2017

WASHINGTON, D.C. – Accurate provider directory information depends on strong partnerships between doctors and health plans. That’s the key take-away from the Provider Directory Initiative, a pilot program conducted by America’s Health Insurance Plans (AHIP) to learn best practices in maintaining accurate and up-to-date provider directories.

Consumers want health care to be simple. That includes being able to get accurate information about what doctors are in their networks, and how to reach their providers. The Provider Directory Initiative was designed to gain an independent view of how best to improve the accuracy of provider directories.

Click here to download the report.

“Health plans are committed to improvements,” says Jeanette Thornton, senior vice president of Health Plan Operations and Strategy at AHIP. “While no one size fits all, health plans are using the results of this pilot to find actionable solutions to ensure a better consumer experience.”

Among the findings:

  • Physicians contract with multiple health plans, and there is no unified process for updating their information.
  • Not all providers rely on the same method of communication. There is a great deal of variation in how much providers rely on phone, email, electronic portal, or fax to communicate with health plans.
  • Providers may prefer one method of communication (such as e-mail). But that method may not be the most effective way for reaching them and getting their information updated.
  • Provider office staff may not be aware of how important it is to keep this information updated, or how to update it. Education and outreach from health plans can help.

Accurate directories require commitment and partnership between providers and health plans, and plans are looking at ways to incent providers to ensure that their directory information is accurate. They are also considering new approaches to integrate and coordinate data, which would make it simpler for providers to send updated information.