Babies With NPIs and Other Errors: What’s Wrong With Payers’ Provider Data?

Payers are feeling pretty good about their provider data strategy. According to a new survey from Healthcare Dive and ProviderTrust, 81% of executives say data is centralized, 92% say it’s clean, and 96% say it’s complete. They also believe the data is automated, well-connected, and continuously monitored. But is this Pollyanna view of provider data management reflective of reality—or is it a false confidence? Some experts worry it’s the latter, mostly because what they’ve seen first-hand is at odds with leaders’ optimistic takes in almost every way.

After looking at provider data for national and regional health plans, analysts have found errors in everything from credentialing and disciplinary actions to providers’ dates of birth (like the doctor whose birthdate was 2024). One payer had a directory of over 4 million physicians, more than the total number of physicians in the U.S. This could be a bellwether for a “crisis of overconfidence,” where errors and siloes go dangerously unseen. In this webinar, we’ll speak with ProviderTrust’s Tony Threatt, Allison Callis and Mike Wirth to explore why the state of provider data management may be more grave than great—and what payers can do to fix it.