AHIP Intiative Seeks to Improve Data from Health Plan Providers

Directories include lists of clinicians, providers, and health care facilities within health plan networks.

America’s Health Insurance Plans (AHIP) is launching a new initiative to help uncover solutions that improve the efficiency and accuracy of data reporting and provider directories.

Health plan provider directories are key tools for individuals and families, and an increasing amount of consumers are relying on these directories to help make a decision on their health coverage.

The directories include lists of clinicians, providers, and health care facilities within health plan networks.

Although these directories provide helpful information for consumers, confirming and updating provider information in real time is a challenge that effects data reporting and maintenance of provider directories.

In order to address this issue, AHIP and 12 member plans from across the commercial, Medicaid, and Medicare markets will test different approaches for coordinating with providers to update and verify directory data.

“Consumers benefit when they have the information they need to make the best decisions about their coverage and their care,” said AHIP President and CEO, Marilyn Tavenner. “Updating and maintaining provider directories is a shared responsibility between health plans and providers. This latest pilot effort is designed to proactively address gaps in reporting in order to improve the experience for consumers and simplify the process for providers.”

The project was developed to help facilitate one primary point of contract for providers when updating or reporting changes to their practice information, rather than receiving inquiries from multiple health plans.

The pilot projects will be launched in California, Indiana, and Florida this month with 12 AHIP member plans participating in the project.