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

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By: Mudeeha Yousaf black LinkedIn logo

Marketing Coordinator

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

The 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.

The CHDS provides a streamlined method for offering members more accurate information that also significantly improves efficiency around directory update 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.

Easily manage your processes, member materials and teams with Blue Relay.

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About The Author

Hi, I’m Mudeeha Yousaf, Marketing Coordinator at Indellient. I’m a tech enthusiast who loves to explore the latest and greatest. In the fast-paced world of tech, it’s important to share stories of success and failure, and I help to tell these tales. I work alongside our subject matter experts and partners to showcase how we are shaping tomorrow. Follow along!