Provider Data Management   /   May 2016

Open Letter to a Provider Directory

Open Letter to a Provider Directory

Provider data is the foundation of a healthcare network, and bad data causes ripple effects that add up to billion-dollar problems across the entire industry. These problems affect doctors, their practices, the payers that have to reimburse claims and manage a huge amount of complexity, and even patients.

We’ve written about the problems that poor data quality causes for payers in prior posts. Today we hear from a health plan member who is not alone in her frustration with the status quo. Solving the systemic problems that lead to consumer frustrations like this is why CredSimple exists.

Dear health insurance provider directory,

I work full time, and I volunteer at my local literacy program. My husband and I are in the midst of the overwhelming process of moving to a new apartment. I’m afraid I have a cavity in my right back molar because I felt some pain there recently. I just returned from my husband’s grandmother’s funeral in Iowa. I am trying to schedule a dinner date with some out-of-town friends.

I tell you all these things about myself to let you know that I am busy. I have a lot to do and a lot to coordinate every day. I know I am not special in my busyness. You might say I have an average level of busyness, and I expect that all your clients understand that.

Because I am busy, I expect technology, including information technology, to help me get through the day. At work, I conduct research using scholarly databases. To find driving directions to Iowa, I used my smartphone. To coordinate the dinner date, I’m using online reservation tools and restaurant review sites. In less than five minutes, I completed an online change-of-address form with the USPS so that when we move, our mail will follow us to our new address.

I also used your provider directory to select a doctor and a dentist. When choosing a dentist, I wanted to find one within walking distance from my work, so I selected a dentist based on the office’s address. I called the office using the number you provided, gave all my information, and made an appointment. Just before hanging up, the receptionist confirmed the time and location of the appointment. Imagine my surprise when the receptionist said the office was located on Brady Street and not Cedar Avenue as listed on the provider profile.

“What? You are not located on Cedar Avenue?”

“Oh no, we moved from that location maybe two years ago.”

I cannot walk to Brady Street. Frustrated at having wasted fifteen minutes of my half-hour lunch break, I canceled my appointment and started my search over.

In the same month, my husband wanted to make an appointment with a doctor. He also used your provider directory and clicked that clever little button that says “Only show providers accepting new patients.” A list of names appeared. He researched the first few doctors and decided on one with good reviews. But when he called the office, they informed him that they were not accepting new patients. What?!

We trusted you. You are a part of our health insurance company, after all. But after getting two major pieces of information wrong in the same month, I don’t have much faith in our health insurance company anymore. If you can’t register a change of address within two years, what else do you have wrong?

I get that you are a part of a big company with many moving pieces. But so what? Figure it out. If Google Maps, Yelp, Wikipedia, the USPS, and even our local library’s book catalogue can stay up to date, so can you.

Yours truly,

Jane

Similar Articles
Feb 02, 2018

Healthcare Industry Shifts Toward Value-based Outcomes

Although there is political uncertainty regarding the future of the U.S. healthcare system, one fact…

Apr 04, 2017

MACRA’s Quality Payment Program: What to Expect

Medicare is forging ahead with a payment program that links physician pay to measured quality…

Feb 14, 2017

25% of Provider Data Became Obsolete in 2016. Don’t Let that Happen in 2017.

Fact: Your business runs on data. That data affects your business every day. Obsolete provider data is…