Candor Health for Health Plans

Know exactly how accurate your provider directory is and fix it

Candor Health's AI-native platform turns fragmented provider data into continuous intelligence — powering accurate directories, compliant networks, and confident attestation

Know exactly how accurate your provider directory is and fix it
Measure

Proof Points

120,000+
sources ingested
4B+
claims processed monthly
95%+
of sources refreshed monthly
How It Works

Navigating Your Path to Clarity and Precision

Step 1

Ingest your roster

Submit your provider roster in any format. Candor Health standardizes and maps it against 120,000+ sources and 4 billion monthly claims.

Ingest your roster
Step 2

Get your Accuracy Scorecard

See exactly what's accurate, what's not, and where, attribute by attribute, with evidence behind every finding.

Get your Accuracy Scorecard
Step 3

Act on a prioritized plan

Your Prioritized Action Plan tells you what to fix, in what order, and why with cited evidence for every correction.

Act on a prioritized plan
Step 4

Monitor continuously

Daily refreshes and proactive change alerts keep your directory current between audits, not just before them.

Monitor continuously
Manage

Built for the Teams Accountable for Directory Accuracy

Network Management & Adequacy

Search providers by specialty and geography to find and recruit the providers you need to fill adequacy gaps and expand your network. Supports expansion into new states and geographies.

Network Management & Adequacy

Compliance & Regulatory

Know your CMS position before the audit notice. Every correction is source-attributed, giving you defensible documentation for attestation and NCQA requirements.

Compliance & Regulatory

Accuracy & Operations

Any roster, any format. Compare your data against 120,000+ sources and get back what's accurate, what's not, and what to fix.

Accuracy & Operations

Member Experience

Clinical expertise data — conditions treated, procedures performed — gives care management teams the depth to match members to the right provider on the first call.

Member Experience
Monitor

Know your accuracy score before the auditors do

Overall Accuracy Score

A single, board-ready measure of directory integrity.

Simulated CMS Compliance Score

Audit-ready visibility into where you stand against regulatory thresholds.

Prioritized Action Plan

For every attribute and inaccuracy: the provider record, what to fix, and cited evidence behind every correction.

Why Choose Candor Health

That's the difference between a directory you maintain and a directory you can defend

Accuracy & Reliability

Accurate, reliable provider data on 7.5M healthcare individuals and 1.2M healthcare facilities.

Unlock Your Accuracy Insights

Measure, manage, monitor with roster ingestion, accuracy scorecards, and search UI.

Strategic Action Plan

Fill gaps, maintain network adequacy, plan expansion of your network.

FAQ

Health plan questions, answered

What health plan teams ask before running their first Accuracy Scorecard.

  • The Accuracy Scorecard is a field-by-field audit of your provider directory. Submit your roster in any format, Candor Health checks every attribute (address, phone, specialty, accepting-new-patients, network status) against 120,000+ sources and 4 billion monthly claims, and you get an overall accuracy score, a simulated CMS compliance score and a prioritized action plan with cited evidence for every correction.

  • The No Surprises Act requires health plans to verify provider directory information at least every 90 days and remove unverifiable entries, and CMS audits directory accuracy for Medicare Advantage plans. A provider data management platform meets those requirements by continuously re-verifying the audited fields — address, phone, specialty, PCP status and accepting-new-patients — and flagging records that fail verification, rather than relying on periodic attestation alone.

  • Continuously. Candor Health re-verifies provider records on a rolling basis with daily refreshes and proactive change alerts, so your directory stays current between the 90-day attestation cycles the No Surprises Act requires rather than only before an audit.

  • Candor Health delivers data through APIs and bulk file exports designed to plug into directory platforms, EHRs, and care navigation tools. Most teams are live within weeks, with no replacement of existing systems required.

Ready to know what's actually in your directory?