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Provider Directory Initiative Key Findings

Research

Document Info

Published on Mar 9, 2017

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Related Issues
Provider Networks

Resource Details

Key Takeaways

  • Health plans are committed to making accurate and up-to-date provider directory information available to consumers. Collaboration amongst plans, and the industry more broadly, is important in finding a solution.
  • Between April and September 2016, AHIP worked with two vendors to contact over 160,000 providers, testing different ways to coordinate with them to update key directory data.
  • Maintaining accurate provider directories is a shared responsibility that requires a joint commitment from health plans and providers to ensure consumers and patients have the information they need and the information is updated in a timely and accurate fashion.

Background

Provider directories are comprehensive listings of the physicians and other clinicians, facilities (e.g., hospitals), and pharmacies that are contracted with a health plan to provide services to their enrollees. These directories, which are usually posted online and in a searchable format, are a valuable resource for individuals and their families. Information such as provider address, phone number, and specialty are typically included in the directory.