Getting More Requests for Directory Verification? Thank the No Surprises Act
By Barbara Griswold, LMFT (July 12, 2022)
Are you getting more directory verification requests from health plans than ever before? Here’s the lowdown — and why you should respond.
This increase is a direct result of the No Surprises Act that went into effect on January 1, 2022. While we all focused on the Good Faith Estimates that this Act required, a lesser-known section of the Act took aim at out-of-date provider directories. The idea was that if provider directories are accurate, this would eliminate the chance of a client accidentally selecting a non-participating provider and getting a surprise bill.
The No Surprises Act requires health plans to verify their own directory information at least every 90 days, so even if you return their call today, in a few months you’ll have to verify again. Some plans have been verifying this info on a regular basis, but many have not, leading to an increase in the number of overall requests. Health plans may do their own verification, or hire third parties to do the verification (e.g. CAQH, Availity, Lexis Nexis, Atlas Services). They may call, email, or send letters.
Remember– while responding to these requests is annoying, if you don’t respond to the verification request, the health plan can suppress your listing from their directory, making it difficult for new clients to find you.