HIT Consultant August 7, 2024
Payers place many resources—including time, personnel, and money—into maintaining provider networks for their plans and members. What is the intended goal after negotiating and contracting with networks? An accurate and comprehensive provider directory containing in-network clinicians and specialists that members can effectively use to “find a doctor” when they need care.
In reality, though, this is often an elusive goal. Members frequently find themselves haunted by ‘ghost networks’ – directories with listings for doctors who are no longer practicing, not accepting new patients, out-of-network, or have listings with inaccurate addresses, phone numbers, and websites. Those lists, constructed from bad or inaccurate data, contain inaccurate information that can hide network inadequacy. Patients have made lawmakers aware of their frustrations with...
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