According to the AMA, the average provider is affiliated with 12 health plans and may undergo a rigorous data audit for each on a quarterly or bi-annual basis. Yet even with this effort, health plan directories remain inaccurate, preventing patients from finding the care they need in a timely manner.
The Symphony Provider Directory streamlines the way you share information with health plans so that you and your staff can focus on patient care.
Instead of juggling multiple requests for the same information, providers can make real-time updates through a single portal or via FTP and are notified when information is accepted by participating plans.
DID YOU KNOW
.5–7 FTEs are dedicated to managing provider data. (IHA market research)
49% of online provider directories for Medicare Advantage Organizations had at least one inaccuracy. (2018 CMS Report)
SB-137 requirements mean providers must validate information or risk payment delays or removal from health plan member directories.
Using Symphony to simplify your workflow
The Symphony Provider Directory supports the needs of large provider organizations as well as small independent practices across California. We know that one process does not fit all. No matter how you currently manage provider data, we connect to what works and partner with you to figure out how to streamline what doesn’t.
How Symphony simplifies workflows for provider organizations
- Reduces labor-intensive and manual roster management by automating the data-exchange process
- Allows sharing of data files in any format and translates it for each participating plan
How Symphony simplifies workflows for small independent practices
- Allows you to update information in real-time through a provider portal
- Provides notifications when updates are accepted so you know when the loop is closed
Supporting state and federal compliance for provider attestation
Attestation is currently a painful process that requires a heavy lift from both provider groups and solo practices. The Symphony Provider Directory not only facilitates real-time updates on a routine basis so that quarterly attestation becomes an easy checkpoint, we also enable providers to formally attest for all participating plans in one place.
State and federal policies require that providers periodically validate and attest to the accuracy of the information that health plans share about them with members.
- SB137 requires that health plans outreach to their contracted providers annually and their directly contracted practitioners biannually, to validate, update and attest that their demographic data in the directory is accurate or is not accurate.
- CMS requires that health plans outreach to their contracted providers and practitioners at least quarterly to ensure that their demographic data in the directory is accurate.
Providers who do not attest within the required timeframe may see a delay of payment and/or removal from health plan member directories.
We are working closely with state and federal regulators as they prepare to update and standardize requirements around attestation.
Read more about how Symphony supports providers in achieving compliance for:
Addressing challenges to sharing accurate provider data
Providers and their staff face a large administrative burden dealing with requests for information from multiple health plans and other organizations. Additionally, keeping track of all the different contractual obligations and other details can be difficult. To help address these challenges, the Symphony Provider Directory:
Leverages primary sources by going directly to the source of truth for each data field, such as a signed contract between a plan and a provider or a national database. This is cuts down on provider fatigue and is more effective than calling provider offices directly.
Consolidates provider directory updates in one place, which allows the Symphony Provider Directory to compare data across all participating plans to flag inconsistencies. If nine out of ten plans have the same provider name, it can be assumed with high confidence that the tenth plan is incorrect, unless that plan is the only one using a primary source.
Brings transparency to the primary sources and data policies, so we can enable plans and providers to identify and act on inconsistencies (or “bad data”), resulting in improved data quality over time.
JOIN THE MOVEMENT
Request an assessment to learn how the Symphony Provider Directory can fit into your workflow.