A few decades ago, the household address book was the single source of accurate contact information for family, friends, and peers. Therefore, it was crucial to keep it properly updated as information changed.
In healthcare, the provider directory is today’s address book equivalent and serves as an important resource for patients. When thousands of physicians move offices and change phone numbers, but payers don’t update their directories – things get messy. And that’s how we end up with a ghost network, confused patients, and costly fines from Human and Health Services.
Watch the latest installment of the Madaket Minute to learn more about ghost networks and why they occur.
Read the video transcript below and subscribe to Madaket Health on YouTube.
Video Transcript:
Hello again, everyone, and welcome to another installment of the Madaket Minute. My name is Martin Cody with Madaket Health, and today we are answering the question: what are ghost networks?
It’s important because it is going to be impacted by HHS fines, the ability of members to be able to find a provider. And to understand what ghost networks are and how they form, it’s probably easier to go back a few decades to the old address book we used to have. The one where you’d scroll to the S’s or the J’s and open it up, and you’d find all the people whose last name began with J. And there was always some cross-outs because people move around, and pretty soon you run out of space for the J’s and you look down and you say, “Mom—Nancy Jones has not lived at this address in 15 years.”
Well, that’s what’s happening with healthcare. And think about it. Extrapolate that out to the thousands upon thousands of physicians that have made changes to their address locations—adding an office space, taking away an office space, adding a new fax number. And the payers aren’t keeping their directories up to date. And then, lo and behold, you’ve got a ghost network where providers are not where they say they are.
Next episode we’re going to tell you how you can solve this. And it’s far faster than you think.
