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CAQH White Paper: The Hidden Cause of Inaccurate Provider Directories

A recent CAQH survey uncovered the administrative burden on providers associated with maintaining provider directories.

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 and requires the equivalent of one staff day per week.

The burden associated with 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. And though individual health plans have worked to minimize the burden on providers in their network, practices must still respond to multiple requests in varying formats and on different schedules for each plan. This fragmented approach taxes practice resources and can result in errors in the information reported to plans.

To determine whether a single platform would reduce administrative burdens associated with directory maintenance, 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. Assuming similar efficiencies between these workflows, this approach 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.

Download the white paper to learn about this problem and how health plans and providers can work together to decrease the burden of directory updates.