Provider data learnings part 1/5 – Improving provider directory data quality when there is scarce, missing or non-existing data

Our journey from a direct-to-consumer app to validating provider data has given us a lot of (sometimes surprising) insight around provider directories, especially in terms of data quality and managing complex provider data systems. In the upcoming weeks, we will share key learnings from our provider data validation work, which has expanded nationwide.

In this first piece, we will talk about the misconceptions that still exist around collecting provider data, the overall data quality, and how to fix your provider directories when there is missing data.

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BetterDoctor Closes on $11M, Expands Nationally to Fix Doctor Data and Health Plan Provider Directories

SAN FRANCISCO (June  20, 2017) —BetterDoctor, a company with a mission to fix provider data and help consumers find the care they need, closed a new $11M funding round led by Health Catalyst Capital. Vision+, Texo Ventures, SoftTechVC, LifeLine Ventures and B-ForeCapital also participated in the round.

Provider data inaccuracy continues to be an ongoing (hidden) problem that overburdens the entire US healthcare system. BetterDoctor is in a unique position to solve this persistent data problem and to ensure health insurance companies, health systems and providers comply with several federal and state regulations.

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Why Fix Inaccurate Provider Data? It Leads to Lower Costs, Better Care, and Satisfied Patients

As uncertainty swirls around the fate of the Affordable Care Act (ACA) and the Republicans’ replacement, the American Health Care Act (AHCA), many patients have only one thing on their mind—finding a doctor who accepts their insurance. For individuals insured under the ACA, either in the state or federal marketplaces or through the Medicaid expansion, increasingly narrow provider networks and lack of choice among insurers makes this an especially important but daunting task.

Penny Gentieu knows this firsthand. She called 308 physicians in six different insurance plans to find a primary care physician (PCP). She discovered that more than three-quarters of the PCPs listed as accepting new patients in her part of Ohio had no openings. Some had not accepted new patients in years, and others listed as PCPs were specialists, nurse practitioners, or medical residents who had not yet completed their training.

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BetterDoctor’s Data Validation Work Helps AHIP Health Plans Comply with Provider Directory Regulations

Independent Report Evaluates AHIP-Led Provider Directory Pilot’s Successes and Challenges

SAN FRANCISCO (March 9, 2017)– America’s Insurance Plans released an issue brief today, conducted by the NORC at the University of Chicago, which finds challenges and opportunities to improve provider directories. The brief is an independent evaluation of an AHIP pilot during April-September of 2016 with member health plans and evaluates the competitively selected data validation work of BetterDoctor and Availity.

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BetterDoctor Selected as Presenting Host Company at NewCo 2017 Bay Area Festival

Join us on February 9th to talk healthcare!

BetterDoctor is honored to to have been selected as a presenting host company at NewCo’s 2017 Bay Area Festival. Over 2,000 attendees and 140+ companies will open their doors to engage our community with innovative ideas. NewCo is an internationally renowned organization whose mission it is to identify, celebrate, and connect the engines of positive change in our society.

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WATCH: BetterDoctor’s Monthly Provider Webinar Series

Does your organization find provider directories a challenge? Could you use more support to navigate the constantly evolving provider regulation landscape?

Join health plans, provider groups, policy makers, and industry experts to discuss the state of provider directories and the best practices to keep them updated and accurate.

Our first roundtable discussion is on Wednesday, February 1st!

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BetterDoctor’s State-by-State Provider Directory Requirements Guide

Today, consumers rely on provider directories to choose the care they need. Updating inaccurate provider data is no easy task. Multiple stakeholders — from providers and provider groups to health plans — are involved to make sure that consumers are getting the information they need from provider directories.

To improve the quality of data in provider directories, states across the nation have implemented and enforced laws to help keep provider directories updated for consumers. We at BetterDoctor understand the challenge and importance of this, so we bring you a provider directory requirement guide.

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