Unlock the Potential in the Claims Data You Already Have to Improve Directory Accuracy

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For health plans, the mandate to better manage provider directory data has grown teeth. A chronic administrative challenge, ensuring the accuracy of information about which providers practice at which locations now comes with significant financial penalties. Medicare Advantage Organizations’ online directories, according to the Centers for Medicare and Medicaid Services, must be accurate – and payers bear the lion’s share of responsibility for making sure the information is correct. If they don’t, they’ll face fines from federal regulators.

This e-brief explores the use of new technology to identify provider inactivity, fight roster inflation and avoid federal fines for inaccurate directories.

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