• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to secondary sidebar
  • Skip to footer

  • Opinion
  • Health IT
    • Behavioral Health
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Patient Engagement
    • Population Health Management
    • Revenue Cycle Management
    • Social Determinants of Health
  • Digital Health
    • AI
    • Blockchain
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • M&A
  • Value-based Care
    • Accountable Care (ACOs)
    • Medicare Advantage
  • Life Sciences
  • Research

Inaccurate Provider Directories Costs Physician Practices $2.76B Annually

by Jasmine Pennic 11/15/2019 Leave a Comment

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Report: Maintaining Provider Directories Costs Physician Practices $2.76B Annually

– Providers spend $2.76 billion each year on provider directory maintenance, a new survey by CAQH found.

– For individual practices, this intensive process costs $998.84 per month–the equivalent of one staff day per week. That is time and money that most providers can’t afford to waste.

– CAQH surveyed 1,240 physician practices last month and just released “TheHidden Causes of Inaccurate Provider Directories“– a new white paper that details the burdens the survey uncovered and what the industry can do to address them.

Inaccurate provider directories have plagued the healthcare industry for years–but a groundbreaking new study from CAQH has quantified, for the first time, exactly how much of a burden maintaining directories is for providers and how that is contributing to errors. The numbers are staggering. For example, physician practices across the US spend $2.7 billion every year just on verifying and updating directory information for plans. The average practice dedicates one staff day per week to the task.

The survey of 1,240 physician practices, conducted in September 2019, determined that directory maintenance costs practices nationwide $2.76 billion annually. Updating directory information costs each practice $998.84 on average every month, the equivalent of one staff day per week.

The Hidden Causes of Inaccurate Provider Directories

The burden associated with the directory maintenance is due, in part, to the fact that the average physician practice updates information for 20 health plan contracts, according to the survey. Large practices may have more than 30 health plan contracts. Although individual health plans have worked to minimize the burden on providers in their network, practices must still respond to multiple requests and submit information in varying formats and on different schedules for each plan. This taxes practice resources and can result in errors.

The Provider Burden

Studies of online directories for Medicare Advantage plans conducted by the Centers for Medicare and Medicaid Services (CMS) found that as much as half of the information contained in directories maybe inaccurate. Because members rely on directories to identify and contact providers in their plan, inaccurate directories can present a barrier to care and result in higher out of pocket costs.

In spite of these challenges, providers see the importance of accurate directories. In a survey released by the American Medical Association (AMA) in January 2018, 52% of physicians said their patients encounter coverage issues at least once a month due to inaccurate directories. To address this problem, 67% of physicians surveyed by the AMA expressed an interest in having their practice use just one interface to send and update information to payers.

Single Platform Approach: The Best Solution to Reduce Administrative Burden?

To determine whether a single platform would reduce administrative burdens, CAQH examined how providers submit similar information for credentialing, in which many practitioners use one channel to provide updates to all of the health plans with which they contract. CAQH determined that practices that use one channel for all plans spend 39.6% less per month than those who use multiple approaches.  Assuming similar efficiencies, using a single channel to update directory information could save the average physician practice $4,746 annually. Nationwide, streamlining directory maintenance through a single platform could save physician practices at least $1.1 billion annually.

Impact of These Findings

“Our nation’s fragmented approach to maintaining provider directories is not only a burden on physician practices, it may be undermining the accuracy of the data,” said April Todd, CAQH Senior Vice President for CORE and Explorations. “Health plans rely on the information providers give them. If we minimize the requests that drive provider burden, we can improve the accuracy of the data.”

“This is going to take an industry-wide solution,” said Todd. “If payers along all lines of business work together to reduce the burden on providers through a single streamlined approach, we can improve the accuracy of directories for all consumers.”

For more information, read the white paper: “The Hidden Causes of Inaccurate Provider Directories”

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Tagged With: AMA, American Medical Association, CMS, medicaid, medicare, Medicare Advantage, Payers, physician practice, Physician Practices, physicians, white paper

Tap Native

Get in-depth healthcare technology analysis and commentary delivered straight to your email weekly

Reader Interactions

Primary Sidebar

Subscribe to HIT Consultant

Latest insightful articles delivered straight to your inbox weekly.

Submit a Tip or Pitch

Featured Insights

2025 EMR Software Pricing Guide

2025 EMR Software Pricing Guide

Featured Interview

Kinetik CEO Sufian Chowdhury on Fighting NEMT Fraud & Waste

Most-Read

Blue Cross Blue Shield of Massachusetts Launches "CloseKnit" Virtual-First Primary Care Option

Blue Cross Blue Shield of Massachusetts Launches “CloseKnit” Virtual-First Primary Care Option

Osteoboost Launches First FDA-Cleared Prescription Wearable Nationwide to Combat Low Bone Density

Osteoboost Launches First FDA-Cleared Prescription Wearable Nationwide to Combat Low Bone Density

2019 MedTech Breakthrough Award Category Winners Announced

MedTech Breakthrough Announces 2025 MedTech Breakthrough Award Winners

WeightWatchers Files for Bankruptcy to Eliminate $1.15B in Debt

WeightWatchers Files for Bankruptcy to Eliminate $1.15B in Debt

KLAS: Epic Dominates 2024 EHR Market Share Amid Focus on Vendor Partnership; Oracle Health Sees Losses Despite Tech Advances

KLAS: Epic Dominates 2024 EHR Market Share Amid Focus on Vendor Partnership; Oracle Health Sees Losses Despite Tech Advances

'Cranky Index' Reveals EHR Alert Frustration Peaks Midweek, Highest Among Admin Staff

‘Cranky Index’ Reveals EHR Alert Frustration Peaks Midweek, Highest Among Admin Staff

Madison Dearborn Partners to Acquire Significant Stake in NextGen Healthcare

Madison Dearborn Partners to Acquire Significant Stake in NextGen Healthcare

Wandercraft Begins Clinical Trials for Physical AI-Powered Personal Exoskeleton

Wandercraft Begins Clinical Trials for Physical AI-Powered Personal Exoskeleton

Chipiron Secures $17M to Transform MRI Access with Portable Scanner

Chipiron Secures $17M to Transform MRI Access with Portable Scanner

Abbott to Integrate FreeStyle Libre Glucose Data with Epic EHR

Abbott to Integrate FreeStyle Libre Glucose Data with Epic EHR

Secondary Sidebar

Footer

Company

  • About Us
  • Advertise with Us
  • Reprints and Permissions
  • Submit An Op-Ed
  • Contact
  • Subscribe

Editorial Coverage

  • Opinion
  • Health IT
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Population Health Management
    • Revenue Cycle Management
  • Digital Health
    • Artificial Intelligence
    • Blockchain Tech
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • Value-Based Care
    • Accountable Care
    • Medicare Advantage

Connect

Subscribe to HIT Consultant Media

Latest insightful articles delivered straight to your inbox weekly

Copyright © 2025. HIT Consultant Media. All Rights Reserved. Privacy Policy |