It’s Time We Improve Provider Directory Data and the Member Experience



Photo of the top of a blue desk with two people sitting on either side, only their arms past the elbow are visible. One has a black blazer, and the other has a white doctor's lab coat pointing to something on a laptop screen that is facing towards the other person. There is also a stethoscope, mobile phone, and a pair of glasses on the desk

BlueRelay helps health plans deliver more accurate and personalized provider directories to members.

Health plans are under pressure to improve the consumer experience in accessing care. As part of their mandate, a Qualified Health Plan (QHP) must provide updated provider directories every 30 days to its members, according to the Centers for Medicare and Medicaid Services (CMS).

With new rules around this required provider data refresh, many QHPs are looking to improve their strategy. But it’s not an easy task.

The Major Pain Points for Providers:

  • Data cleanliness
  • The need for new and automated processes/workflows to support high change volumes
  • How to best improve the member experience
  • Keeping updates at a manageable cost

Provider Directory Solution

As a short-term fix, some health providers are providing an addendum to preprinted provider and pharmacy directories. Basically, when they receive a directory request from a member, a query will be executed in their database to see what provider/pharmacy information has changed.

The data is then printed as an addendum and added into the mailing with the preprinted provider or pharmacy directory. However, this method becomes labor intensive and offers a sub-par experience to members.

As QHPs are managing several complex programs at once, they need an efficient process to provide frequently updated and accurate provider directories that do not significantly increase resources.

The Key to Long-Term Efficiency & Accuracy

BlueRelay is the long-term solution QHPs need if they want to beat the competition and provide a superior customer experience. To help address data quality issues, we help with the broader vision, which is to make the member experience better by offering more targeted, local Provider Directories specific to each member.

Our Compliant Healthcare Directory Solutions (CHDS) was developed to understand the challenges health payers have and then develop a solution that is configurable to each unique client environment.

CHDS significantly improves efficiency around directory creation and maintenance processes. It significantly lowers the barriers to compliance requirements and uses geocoding to pinpoint each member’s location for more accurate results and unique experiences.

As an added benefit, BlueRelay reduces error in your regulated communications and keeps you up-to-date with new CMS guidelines.

Just see for yourself how we’ve helped real health plans unlock new efficiencies.

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About The Author

Indellient is a customer-driven professional services company that specializes in tailor-made software and tech solutions. We enable your business to get back to business with Business Process Automation, Document Management Systems, Business, and Operational Insight. Your companies Digital Transformation doesn’t have to be difficult, concentrate on what you do best and Indellient handles the rest.