How to Meet CMS Guidelines on Provider Directory Data

Improving Provider Directory Data

To improve the member experience in finding the right healthcare provider, the Centers for Medicare and Medicaid Services (CMS) requires all Qualified Health Plan (QHP) issuers to ensure their provider directory data is updated with accurate information every 30 days. In some states, it can be as short as every 10 days.

Rethinking Provider Directories

With new rules around the provider data refresh and network adequacy, many organizations are rethinking their provider generation strategy and asking:

How do we best manage provider data across all programs?

How do we ensure we continuously hit the 30-day or less mark?

How does this impact our member experience?

How do we manage updates without adding resources and/or incurring high maintenance costs?

Well, we have the answers for you.

The On-Demand Solution That Meets Your Needs

The Compliance Healthcare Directory Solutions (CHDS) was designed by a team with years of experience in data cleansing and management, software development, IT integrations and workflow management. Combining these strengths, we have designed a world-class tool to help health payers:

Decrease delays in applying provider updates to ensure accurate and tailored directories

Meet compliance regulations and,

Improve the member experience without increasing resources and costs

A scalable solution that fits your business rules.