Survey Finds Physicians Need More Accurate and Efficient Network Directory Systems

More than half of physicians find that their patients encounter coverage issues due to inaccurate information included in payer directories at least once per month, according to a survey from the American Medical Association (AMA) and LexisNexis Risk Solutions.

From December 2017 to January 2018, 703 physicians in the United States were surveyed to evaluate their experience with network directories. These physicians found that network directories are not a critical tool for patients when making decisions about their personal healthcare, as patients can incur more healthcare costs when using an out-of-network doctor based on inaccurate data from a network that has not been updated.

The survey found that 52% of the provider locations listed on network directors had at least one inaccurate piece of information. From these results, federal officials have issued 23 notices of noncompliance and 31 warning letters this year to Medicare Advantage plans.

“Recognizing the importance to patients of high-quality directories, federal and state governments have created regulations requiring health plans to increase the frequency of physician data verification,” Laurie McGraw, senior vice president of AMA Health Solutions, said in a press release. “As a consequence, some physician offices have experienced an increase in repetitious data verification requests from health plans that are mandated to constantly ensure the quality of network directories.”

Other data found that 73% of physicians are not aware of mandates related to the accuracy of payer directories, and 89% find it is important to be represented accurately in directories. More than three-fourths of physicians believe that their practice information is represented accurately in payer directories.

While 46% of physicians receive requests from payers and patients to update their directories, one-fourth of those physicians receive 3 or more requests per month. Two-thirds of physicians do update their information for payers. The survey found 67% expressed interest in having their practice use only one interface to send information about their services and providers to payers.

“Ensuring the accuracy of network directories needs to be a truly collaborative process for physicians and health plans,” said McGraw. “Physicians want patients to make informed healthcare choices, while health plans seek to comply with mandates to publish the most up-to-date network directories.”

AMA and LexisNexis released the survey to collaborate on a solution to these inaccuracies in network directories. VerifyHCP was launched by the 2 organizations in March 2017 and is powered by AMA Business Solutions and enabled with LexisNexis analytic technology. The program offers a flexible way to update practice details for multiple health plans and reduces administrative tasks.

“We knew there had to be a better, more efficient way for physicians and their office managers to simultaneously update practice details for multiple health plans,” said Josh Schoeller, vice president, Client Engagement, LexisNexis Risk Solutions in a press release. “The solution was in the data. LexisNexis houses one of the most comprehensive provider databases and, in combination with the AMA’s extensive relationships with physicians and practices, we developed a solution that uses a single sign-on and has the ability to pre-fill, collect, monitor, cleanse and update data in an easy-to-use, efficient manner.”