Insurers Required To Update Their Doctor Directories

CONSUMER TRENDS NAVIGATOR

 

INSURERS REQUIRED TO UPDATE THEIR DOCTOR DIRECTORIES

Consumers rely on insurance company’s hospital, laboratory, doctor and other directories to plan their healthcare.  Insurance companies have been lax in updating the directories misleading consumers.  Recent studies have shown that 35% of the directories have errors.  To make thing more complicated, 30% of the doctors change their affiliations each year.   Additionally, some states are enacting regulations to force insurance companies to update their directories.  Effective January 1, 2016, the Centers for Medicare and Medicaid Services (CMS) can fine insurance companies $25,000 per beneficiary for errors in Medicare Advantage Plans and up to $100 per beneficiary for errors in plans sold on federal exchanges.

Before consumers select their insurance plan, they should:

Call their healthcare providers to make sure their insurance plan is accepted.  Unfortunately, the provider will know more than the insurance company.

Healthcare Consumer Navigator Center will be monitoring this very important consumer issue.

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