Improving the Accuracy of Health Insurance Plans’ Provider Directories

Provider directory inaccuracies have caused problems for consumers and other stakeholders for many years. Our issue brief (PDF) explains the steps policymakers and health plans can take to improve directories and provides examples of legislation and regulation to help eliminate provider directory inaccuracies. Policymakers at the state and federal levels should make this issue a priority both for private insurance and for public programs like Medicaid, as accurate provider directories are critical to ensuring that coverage works for consumers.

Accurate provider directories are important for many reasons:

• They protect consumers from inadvertently visiting out-of-network providers who could leave them with high bills
• They allow consumers to correctly identify providers who meet their language, location, and other needs
• They create a true picture of which providers are actually in a plan’s network, making it easier to assess whether or not a network is adequate

By committing to take steps to address provider directory accuracy, federal and state policymakers, as well as health plans directly, can make a meaningful impact on consumers’ health insurance experience and access to providers.