Provider Data Inaccuracies Solved: Introducing the Candor Accuracy Scorecard

For decades, “How accurate is our provider directory?” has been a question most healthcare organizations could only answer with a shrug. They knew it was a problem: members complaining about addresses and phone numbers being incorrect, claims not resolving, the ghost-network lawsuits, the CMS penalties. And, the consequences were steep: Up to $10,000 per violation under the No Surprises Act; civil penalties for repeated inaccuracies or failure to correct (REAL Health Providers Act); impacts to NCQA accreditation and STAR/HEDIS ratings.

But knowing something is broken and knowing exactly where, why, and how to fix it are very different things.

Today we’re answering that question. Meet the Candor Accuracy Scorecard.

Provider data inaccuracies solved

Improvement starts with knowing where you stand. The Accuracy Scorecard takes your roster and measures it against Candor’s purpose-built agents that run across 120,000+ sources and 4 billion+ claims processed every month to give you a clear, defensible baseline. You get a number, backed by evidence, that leadership can stand behind.

The Scorecard turns a vague worry into three clear measures:

• Measure: the overall accuracy of your provider data, so you have one baseline to work from.

• Monitor: your alignment with CMS benchmarks, so you know where you stand against the standard you’re held to.

• Maintain: the actions to take to resolve inaccuracies and keep the integrity of your data over time. Progress is tracked after every change instead of frozen in a point-in-time audit.

Together, they give you full visibility into every gap and every opportunity.

From raw data to a plan you can act on

Understanding your data is only the first step. The Scorecard dives deep into each core attribute for a provider data record to give insight into how to improve. So whether it be the provider’s specialty, location, phone, or accepting new patients - the Scorecard outlines which records to update and why. For each provider, know which attributes to keep, which ones to remove, and which ones to update. Whichever path you choose, your team can continuously monitor, systematically improve, and confidently maintain accuracy over time.

Why this matters now

Provider data has been treated as a back-office checkbox for too long. It isn’t one anymore. Directory accuracy is core to NCQA accreditation, tied to STAR and HEDIS performance, and exposed to CMS audits and penalties under the No Surprises and REAL Health Providers Acts. The organizations pulling ahead have stopped treating accuracy as a periodic clean-up project and started managing it as a continuous discipline. The Scorecard is how they keep score.

The Scorecard is built on the same infrastructure our customers already rely on: 250M+ records analyzed monthly, 106K+ changes tracked. In one health plan’s directory, that intelligence surfaced issues spanning across inactive providers, outdated locations, incorrect phone numbers, and more. The data is now ready for members to find and search across all their entire US network.  This is what it looks like when provider data becomes something you can trust and measure.

We know provider data is hard to get right. That’s why we made managing it easy. Request a demo now to see how the Accuracy Scorecard works.