Insurer Provider Directories are up to 74% Inaccurate

By Thomas White | December 03, 2014

business

Hospitals aren’t the only institutions struggling with inaccurate provider data. In a recent article from the Wall Street Journal titled ‘Insurers’, listings of in-network doctors often out-of-date,” Author Melinda Beck cites a JAMA research article that showed that only 26% of providers in California were listed correctly. Inaccuracies include missing phone, fax, and address or the provider is no longer included in the insurance network. 

It turns out Insurers and hospitals suffer from the same issue. To that point, this is what we heard recently from one large hospital system: “Historically, our health system struggles, as do most health care systems managing and maintaining our credentialed and non-credentialed provider information in our multitude of databases and systems.” 

The traditional model for Hospitals and Insurers have been to utilize database technology to store and disseminate provider information. Unfortunately this has perpetuated bad data in resulting in bad data out. These institutions lack the modern platform to keep their information up to date as a WSJ article states “Many physicians say insurers aren’t responsive to their complaints about inaccurate listings.” (Listings of In-Network Doctors Often Out of date, 2014) Just like other industries that are being disrupted by new technologies (Uber, Airbnb and other), the provider data industry is ripe for change. 

The PHYND Provider Network Management Platform leverages the cost benefits and access of the cloud, with the power of the social network coupled with decentralized work-flow tools for employees engaging with providers and apps for the providers themselves. The result is fresh, accurate and custom provider data that improves clinical communications, revenue cycle management and healthcare efficiency. Interoperability is simplified with the PHYND Mapper tool that works with flat files, HL7, Web Services and a custom API.

Thomas White

Written by Thomas White

Before founding Phynd, Tom co-founded Newscast Inc. and Vocada, Inc. With over 20 years of leadership experience, Tom has applied his knowledge in building software companies and creating new software categories from idea to large market share. He also serves as a mentor to the start-up accelerator Health Wildcatters.

Subscribe to our Blog