Big Insurers Back a Shared Standard for Doctor Directories as Medicare Enrollees Still Face Ghost Network Errors

Several of the country's largest health insurers have joined a new group that aims to make the doctor information in their online directories more reliable. DataSpring, the insurer-owned data company formerly known as CAQH, announced the Provider Data Collective and its first standard on October 13.

Founding members are Aetna, Centene, The Cigna Group, Elevance Health, Horizon Healthcare Services, Humana, and UnitedHealth Group, along with the American Medical Association (AMA), the National Committee for Quality Assurance (NCQA), and DataSpring itself. The group's first product is a common way to measure the quality of directory data for individual clinicians, including office locations, whether a doctor is accepting new patients, which health plans they take, and their licenses and credentials. DataSpring said the framework builds on the quality foundation the Centers for Medicare & Medicaid Services (CMS) uses for provider directories and was developed in three months. The group said its next focus will be how a doctor's "accepting new patients" status is determined, updated, and displayed.