Provider directory accuracy
Provider directory accuracy is how much of a directory is correct: whether each listed provider really practices at the listed location, can be reached at the listed number, accepts the listed plans and is taking new patients.
How is directory accuracy measured?
Two common ways. Secret shopper surveys call a sample of listings and record what's wrong; CMS used this method in its reviews of Medicare Advantage directories. Field-level checks compare every field in every listing against outside evidence and score each one. The first gives a rate for a sample. The second shows exactly which records to fix.
What accuracy rates have reviews found?
CMS's third review of Medicare Advantage directories, published in 2018, found that 48.74% of provider locations had at least one inaccuracy. A 2024 Pennsylvania study found many errors were still there months after plans were told about them.
Why accuracy, not just completeness?
A directory can have every field filled in and still be wrong. Accuracy is what members feel when they call, and it is what directory rules measure.