Consulting Connection Blog

Provider directories have long been a challenge for hospitals, health plans, and insurers alike. Clinics are constantly opening new locations, changing addresses or suites, hiring new providers, and opening or closing the door to new patients. Managing these changes can become overwhelming without established processes in place.

Here are five actions you can take today to ensure that your provider directories are accurate:

1. 1. Establish a defined process for address changes. Too many cooks can spoil the broth, and maintaining address records is no different. One database should be established as your single source of truth for provider data, whether you use a credentialing software program or a spreadsheet. Only a very small number of users should be allowed to maintain addresses within that system in order to preserve the integrity of the address data.
2. 2. Spread the word. Once you know who will be updating your addresses and where, let providers, office managers, and other departments know. You might even consider sending out a communication to providers and office managers on a regular basis to let them know what information you have on file and how to change it.
3. 3. Determine valid sources and approvals for provider addresses. As we know, address change notifications can come from many sources. How will you determine whether an address change is valid? Will you automatically change an address that a provider modified on her reappointment application? Will you assume that other departments that notify you of an address change have the correct information? Does your provider enrollment team need to have some say? Decide in advance what your protocol will be and how you will validate changes that you receive.
4. 4. Be consistent in sharing changes to locations. Once you have determined that an address change is valid, you need to determine how to share those changes with the appropriate parties, including payers and online directories. You will want to partner with the recipients of this data to determine timeframes and what information they need about the new or removed addresses.
5. 5. Consistency is key. Establish data standards to decide whether you’ll spell out Street, whether suite numbers will be on the same line as the street address or a separate one, whether you will abbreviate city names, and more. The tighter your protocol around how addresses are entered, the cleaner your data, and the easier it will be for your patients.

Provider directories are a highly visible glimpse into a portion of your department’s work. Keeping things clean, accurate, and current will help you to put your best data foot forward.