The COVID-19 health crisis has exacerbated the industry’s provider data management challenges but in a different way. Under the CMS rulings, health plans have invested heavily in provider directories over the past few years. Then, a global pandemic hits and the game changed again. Inaccurate or incomplete provider directories have always been a challenge for members there hasn't been burning platform for Health Plans to invest in addressing such a complex ecosystem of information. Inaccurate directories create burdens for everyone involved: Patients receive “surprise bills” because they visited a physician who they believed was in-network but was in fact erroneously listed in the provider directory and busy providers are often called to verify their practice information to keep directories timely.

In 2016, CMS published rulings requiring Health plans administering Medicare Advantage to maintain accurate provider directories for members….and the game was changed.