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BetterDoctor Teams Up with Washington Health Benefit Exchange to Reduce Administrative Burden for Providers and Improve Online Provider Directories

Providers can now reduce the administrative burden of verifying doctor information by updating provider information via BetterDoctor

SAN FRANCISCO, CA (August 21, 2017) — BetterDoctor, a company with a mission to fix provider data and help consumers find the care they need, is proud to announce its partnership with the Washington Health Benefit Exchange to power Washington Healthplanfinder, the state’s health insurance marketplace, when the next open enrollment period begins on November 1, 2017.

To ensure a seamless consumer experience, BetterDoctor consolidates provider data from all participating health plans and reaches out to each provider to verify that their information is accurate and up to date. As of July 2017, BetterDoctor works with 14 health plans servicing Washington Health Benefit Exchange and validating their roster data. This is in addition to the multiple more health plans working with BetterDoctor, such as CareMore, Humana, and Western Health Advantage. Offering providers a single place to update their information online significantly reduces a provider’s administrative burden.

Traditionally, the data verification process has been done over the phone or paper by each health plan separately, which has been very time consuming for both the providers and practice staff. In an effort to reduce the administrative burden, BetterDoctor verifies data on behalf of multiple health plans and lets providers and staff use an online portal to verify their data. Online data verification improves data quality and saves providers time. It also ensures that consumers are able to find a doctor with the right address and phone number.

“Partnering with BetterDoctor achieves our goal of connecting Washington Healthplanfinder consumers with the most accurate provider directory information available. BetterDoctor’s online portal allows us to easily update provider data, which ultimately enhances Washingtonians’ access to quality care.”
Paul Winder
Senior Plan Manager for the Washington Health Benefit Exchange

The BetterDoctor data validation process reduces provider burden and updates Washington Healthplanfinder’s provider directory in real time. First, BetterDoctor uses email, fax, mail, and phone to deliver secure access tokens to providers. Providers then use the token to access the BetterDoctor online portal where they can confirm or edit their information. The edits are then submitted in real time to Washington Healthplanfinder’s provider directory.

Andrew Kobylinski, BetterDoctor’s Head of Platform is excited to work with Washington Healthplanfinder, “We’re a group of Silicon Valley nerds disrupting the old and inefficient processes with an eye and ear to what consumers want to see and how providers want their information used. We are dramatically improving communication between health plans and providers. Ultimately, having accurate provider information and directories help the consumer have a better online insurance ‘shopping’ experience. The BetterDoctor team wants to make sure consumers can always find a doctor when they need one.”

BetterDoctor’s work has helped multiple health plans comply with provider directory regulations and adopt cost efficient ways to manage provider data. In addition to working with Washington Healthplanfinder, BetterDoctor is trusted by providers who contract with health plans in all 50 states.

For questions

For questions about this new partnership or provider directories, please contact press@betterdoctor.com.

If you are a provider and have any questions about the update process, don’t hesitate to contact BetterDoctor directly by phone or email. Their support staff is available from 9:00 a.m. - 5:00 p.m. CST for calls at 844-668-2543, and anytime by email at support@betterdoctor.com.

If you are a health plan and would like to join our growing alliance of health plans, please contact us at data@betterdoctor.com.

Frequently Asked QuestionsWhat you need to know.

Who is BetterDoctor?

BetterDoctor helps health plans and providers get compliant with new provider directory regulations.


Why am I being faxed to verify my information?

BetterDoctor faxes providers on behalf of the Washington Health Benefit Exchange’s contracted health plans to help consumers find the latest, most up to date information on provider directories. This fax directs providers to an online portal where they can securely update their information.

Additionally, federal and state rules require providers – doctors, practitioners, etc – to verify information about providers and their practice with each health plan he/she contracts with.


Why am I being asked to verify my information?

New rules require you to verify information about yourself and your practice with each health plan you contract with.

Current Federal Requirements:
  • Medicare Advantage Standards
  • Exchange/Marketplace
  • Medicaid Managed Care

Who and what is the BetterData Alliance?

The BetterData Alliance is a partnership between BetterDoctor, Inc. and the health plans we work with to make provider directory data more accurate. It started when America’s Health Insurance Plans(AHIP), and health plans joined forces to accomplish the goal of easing the process of updating information for providers.


How often am I required to verify my information?

CMS requires health plans to reach out to providers on a quarterly basis.

WAHBE health plans have partnered with BetterDoctor to reduce providers’ administrative burden and simplify the process of updating information with contracted health plans.


How will providers’ verified information be used?

The data you verify will be securely shared with participating health plans to update Washington Healthplanfinder.


The name on the fax is not a provider practicing at my location. What do I do with this information and form?

If you receive a fax and the provider is not at your location, it is important to let health plans know this information has changed. This is one of the key reasons why it is important to consistently verify provider directory information.

What if I've already validated with a health plan or another company?

It’s important to make provider directory updates with BetterDoctor because the data is used in different places, based on who is reaching out. BetterDoctor shares the validated data they receive directly with Washington Healthplanfinder, which is then reflected on the state exchange website. This information is also shared with the 13 health plans that Washington Healthplanfinder contracts with, however the data may not cover the health plan’s entire network and may not reflect on the health plan’s website immediately. For this reason, it’s best advised that provider’s offices should validate through both avenues.


What are the consequences of not complying with outreach requests?

Failure to verify your information may result in any of the following corrective remedies: removal from health plan print or online directories, delay of payments, or, for a repeated pattern of non-responsiveness, termination of health plan participation agreements.


Why are accurate provider directories important to consumers and health plan enrollees?

Health plan enrollees need accurate information about which providers and facilities they can visit in-network. Consumers need accurate information about the providers and facilities that are in health plan provider networks when shopping for coverage.

How does BetterDoctor’s provider data validation platform work?

  1. BetterDoctor takes health plan provider roster.
  2. Uses effective multimodal outreach methods to validate data from each provider.
  3. Validated data is then exported to health plans to update their provider directory.

In 2016, BetterDoctor ran an AHIP-sponsored pilot with nine health plans in California and Indiana. After the positive pilot outcomes, BetterDoctor expanded validation work nationwide.


Still have questions?

If you are a provider and have any questions about the update process, don’t hesitate to contact BetterDoctor directly by phone or email. Their support staff is available from 9:00 a.m. - 5:00 p.m. CST for calls at 844-668-2543, and anytime by email at support@betterdoctor.com.

About BetterDoctor

BetterDoctor validates and delivers accurate provider directory data to health plans, health systems, and hundreds of other companies via its API — from startups to publicly traded ones — to help health plans be regulation-compliant and help consumers successfully find the healthcare they need.

About Washington Healthplanfinder

Washington Healthplanfinder is an online marketplace for individuals, families and small businesses in Washington to compare and enroll in health insurance coverage and gain access to tax credits, reduced cost sharing and public programs such as Medicaid. The next open enrollment period for Washington Healthplanfinder is set to begin on November 1, 2017.