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Health Plans Aim to Improve Provider Directories with Pilot

BY SARAH SUMMER -- To help improve the accuracy of provider directories that have posed challenges for consumers, providers and health plans in recent years, America’s Health Insurance Plans (AHIP) announced a pilot program in California, Indiana and Florida that will change the way providers report information.

The pilot that will launch in April and run through September, and will be run by BetterDoctor in California and Indiana and Availity in Florida.

The pilot introduces a single database for more than 100,000 health care providers to verify and report any changes to their practice, location, contact and other demographic and network information. Currently, providers have to report changes to each of the multiple health plans with which they contract. A single source will maximize efficiencies, ease the burden on providers and help the 15 participating health plans (eight in California) – including Blue Shield of California, Anthem, Cigna and Health Net – update provider data more quickly and effectively.

Blue Shield President and CEO Paul Markovich is leading the task force on this pilot. Once it is completed, AHIP will conduct an independent evaluation and develop best practices to make the program national.

Here is what some of the key drivers of this program said during a press conference to announce the pilot:

  • AHIP President and CEO Marilyn Tavenner: “This is a shared responsibility between health plans and providers and it requires a commitment from both sides to ensure consumers have the right information that they need.” (Bloomberg BNA)

  • Paul Markovich: “It’s imperative we get accurate information to consumers on their providers. We recognize that it takes both providers and health plans to make this work. We’ve focused on making it as simple as possible for providers to update this information.” (Healthcare Finance)

  • Co-Founder and CEO of BetterDoctor Ari Tulla: "Doctors love the fact that they can report information in one place and release the data to participating health plans. We notify our plans of changes in real time and make sure their doctor directories are up to date." (MedPage Today)

Sarah Summer is deputy director of public policy at Blue Shield of California