Provider directory accuracy helps people find care. Today’s fragmented verification process pulls time away from the teams that keep care moving.
Provider directories are supposed to make healthcare easier to navigate. When patients need a primary care doctor, specialist, or behavioral health support, the directory is often where they start. Accurate information tells them who is in network, who is accepting new patients, and how to make an appointment.
That goal matters. Behind every listing, a practice team keeps information current: front desk staff answer phones, office managers manage schedules, and clinicians move between patient needs. Then another verification request arrives.
Each request serves a real purpose. Plans need current information; patients need reliable directories; and regulators expect accuracy. When each plan asks for similar information on different timelines, a necessary task becomes recurring work. Verification is not the problem. Fragmented, plan-by-plan outreach creates the burden.
From my clinical perspective, this is more than an administrative issue. Every repeated verification call competes with the same limited time practices need for scheduling, care coordination, and direct patient support. Fragmented provider data processes often place the burden on the teams closest to patients.
Federal requirements, including rules tied to the No Surprises Act, Medicaid and CHIP managed care, continue to raise expectations for timely, accurate provider directory information. Health plans must verify directory information at least once every 90 days.
These expectations are a critical part of quality healthcare. Reliable directories help patients avoid dead ends, reduce confusion, and make informed decisions about where to seek care.
Higher expectations need better workflows. Nearly half of verification requests still happen by phone, and health plans often manage outreach independently. For practices, maintaining directory accuracy can mean fielding disconnected requests instead of confirming information through one coordinated process.
Verification calls may seem small in isolation, and they arrive inside already busy clinical environments. Even a few extra calls can interrupt front-office workflows, pull attention away from patients in the moment, and make data maintenance feel like a recurring burden instead of a shared responsibility.
DataSpring’s recent Call Verification Insight Brief asked clinicians and practice staff what directory verification looks like from their side of the phone. Their responses show how quickly the time adds up.
More than one-quarter of practices said they receive 15 or more verification calls each month. Forty percent of those calls last more than 15 minutes on average. For those practices, calls alone can consume at least four hours every month.
The impact is not abstract. In the survey, 82% of respondents said verification calls leave less time for patient care. Sixty-eight percent cited workflow disruption. Fifty-five percent noted longer patient wait times.
Provider data may look like an operational field or directory listing, but it sits close to the patient experience. A wrong phone number, outdated location, closed panel, or unnecessary repeat request can create friction before care ever begins.
The conversation needs to move beyond compliance because accuracy matters when access matters. Inaccurate or hard-to-maintain provider data affects more than directory usability. It shapes whether patients reach the right office, understand who is available, and get connected to care without avoidable friction. Better data infrastructure supports a better first step into care.
Provider information still needs verification. Practices, plans, and technology partners can strengthen accuracy without asking the same teams to confirm the same data multiple times through separate platforms, formats, and timelines.
The industry already agrees provider directory accuracy matters. The next phase requires a more coordinated model that makes provider data easier to maintain and easier to trust.
A stronger model starts with a simple idea: collect data once, fix it at the source, and power accurate information across all health plans. That preserves accountability, reduces repeat outreach, gives practices time back, and strengthens the information patients and plans depend on.
This direction calls for greater standardization, coordinated outreach, and trusted infrastructure designed for busy clinical environments.
At DataSpring, we believe no single organization can solve provider data quality alone. Our Provider Data Collective advances a more constructive path by bringing industry stakeholders together to address shared challenges, including call verification, and build greater coordination across the provider data ecosystem.
Provider directories are too important to depend on fragmented workflows. Patients need information they can trust. Plans need confidence in their networks. Practices need processes that respect their time and let staff focus on care.
Directory accuracy will always require attention, and practices should not have to answer the same questions again and again. Healthcare can build a more coordinated provider data foundation that makes accurate information easier to maintain and trust.
The goal is to make verification smarter, more coordinated, and less disruptive, so accurate provider data supports care instead of competing with it.
Download DataSpring’s Call Verification Insight Brief to see the findings behind the burden and why a more coordinated approach to provider data matters now.