# Tricks of the Trade to Keep Your In Tip-Top Shape

## INCREASING PROVIDER DIRECTORY

## ACCURACY OVERSIGHT

**Provider data accuracy and transparency are common**  
**themes in significant health policies.**

**If you partner with a health plan, it’s**  
**important to know the various**  
**regulations and put standard operating**  
**procedures in place to be compliant.**

**NQTL**  
**Comparative**  
**Analysis**  
**Requirement**  
**for Mental**  
**Health Parity.**

## PROVIDER DATA IMPACTS YOUR DIRECTORY

A typical Provider Network  
includes anywhere from

**10-30%**  
of providers who are  
**NO LONGER PRACTICING.**

**Inaccurate provider directories can**  
**hinder the ability of consumers to**  
**access healthcare services.**

## THE BUILDING BLOCKS FOR A TOP-NOTCH PROVIDER DIRECTORY

**One way to minimize your risk and increase your member satisfaction is by maintaining**  
**accurate provider data. We recommend you have a continuous, automatic process for**  
**validating and auditing the information for each provider in your network.**

**Include Providers who**  
**verified data as required,**  
**and with no "red flags"**  
**related to consumer**  
**access.**

**Include but investigate**  
**Providers who verify**  
**data as required, but the**  
**data inspection reveals**  
**concerns about access.**

**Providers who do not**  
**verify data in the**  
**required timeframe**  
**are removed from**  
**the directory.**

**PROVIDER**  
**DIRECTORY**

## KEY ITEMS TO LOOK FOR

Provider NPI  
**Are there deactivated, invalid,**  
**missing or OIG Exclusion**  
**listed NPIs in your data?**

**Suspect Specialty**  
**Combinations**  
**Which providers are listed**  
**with multiple specialties?**

**Number of Addresses**  
**Which providers are**  
**listed with multiple**  
**practicing locations?**

**ProTip:** Fix any incorrect information and then evaluate your provider network to make sure  
you **still meet the network adequacy requirements.**

## QUESTIONS?

## Let’s strategize together!