Provider Directory Pilot Program Overview And FAQ

Program Overview

A critical issue for both health plans and consumers is the accuracy and completeness of provider directories. Provider directories are a key resource for individuals and their families as they consider which health plan to enroll in and select providers for their care.

Today, health plans employ a variety of approaches to maintain and update provider directory data, including scheduled phone calls, follow-up faxes, emails, and in-person visits. These multifaceted outreach efforts are in addition to contractual requirements between health plans and providers to ensure information is accurate and up-to-date.

However, given the diversity of providers in health plans’ networks, data can quickly become out of date. Moreover, not all providers rely on the same method of communication. This often leads to delays in updating pertinent provider information. AHIP’s latest initiative will explore solutions to proactively address these issues.