The report, titled The State of Provider Data Accuracy, identifies five core fields—address, location name, phone number, fax number, and specialty—as the primary sources of systemic errors. These inaccuracies create a ripple effect, compromising regulatory compliance, claims processing efficiency, and credentialing workflows. Currently, only 31% of health plan members express confidence in their plan's ability to direct them to the appropriate care provider.
Health Plan Provider Directories Struggle with 50% Accuracy Rate
Only half of all provider data in U.S. health plan directories is accurate, according to new research from Perspecta. The analysis of millions of records over the past year reveals that traditional manual validation methods are failing to keep pace with the rapid, continuous changes in healthcare provider information.
Mark Stamper, Director of Data Operations at Perspecta, noted that data decay is a persistent management challenge rather than a periodic hurdle. The findings suggest that relying on standard attestation cycles is insufficient for modern healthcare operations. Instead, the firm advocates for continuous, systematic auditing to maintain network adequacy and member trust. The study provides a framework for health plans to benchmark their current data health and transition toward more scalable, automated governance models.
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