In The News

Health Plan Provider Directory Data Should Be Updated Monthly For The Patient's Sake

Healthcare IT News, Staff Writer

On Nov. 13, 2015, the Centers for Medicare & Medicaid Services updated guidance in the 2016 Call Letter and Medicare Marketing Guidelines that previously called for health plans to update provider directories on a monthly basis. Unfortunately for patients, the data is now required to be updated on a quarterly basis – leaving patients with data that is up to three months old when they need health care.

These regulations were initially set because provider directories were found to be inaccurate – with many patients reporting unexpected out-of-network fees after their provider was incorrectly listed as in-network. It’s why beginning Jan. 1, 2016, health plans will face fines of $25,000 per beneficiary for incorrect listings. Read more…