The frustration over provider websites

I find it so frustrating that verifying your provider is listed on the appropriate website has become a full-time job!  In this day and age, not being listed as a provider on-line with various insurance companies you are contracted with can take you right out of the running for potential new patients.  Who is verifying that you are listed, you ask?  No one!  As I’ve mentioned before, with payors such as ASH being a gatekeeper for companies like Aetna, Cigna, etc. you assume that they are updating them appropriately and that they are updating their websites accordingly.  Not the case.

I find so many inconsistencies, it’s scary.  Recently, a long-term ASH provider in my office received a work comp referral from Cambridge insurance.  First of all, what the heck MPN does he need to belong to to accept that?  The MPN section of this very website has been a valuable tool for me, the author of it.  Having all information handy helps me figure out easily the answer to this very question.  The answer, of course, was that he needed to be on the Anthem MPN.  Well, great, he’s an ASH provider and so he’s automatically on it….or is he?  I can’t find him as a provider when I do a search on the Anthem MPN site!  I contact them and say, why don’t you have him listed and they say I need to talk to ASH.  They show that he use to be a provider but opted out and some point and if I want it corrected, contact ASH.  I did just that.  ASH says, as we suspected, he has NOT opted out of anything and should be a provider but they will send an update to Anthem anyway letting them know this.  I too copy and paste this message from ASH reiterating that he’s a provider and to please update their site. Here I sit, 10 days later, checking Anthems MPN site everyday to see if he’s listed yet and guess what?  He’s not.  They tell me to be patient and wait a bit longer…in the meantime, the patient waits to get treatment or see’s a different provider who is listed on their site because, guess what? If you are not listed on the website, you are not a provider in the insurances eyes.  It is imperative that you regularly check ALL the sites you are contracted with to make sure you show up, otherwise, no-one else will and you will miss out on potential patients.  The problem I have with this is that I simply don’t have the time!  I’m now going to hire someone to do this for me because I can’t afford to not have my providers show up.  Technologically is amazing but as efficient as it makes us, it can definitely also have the opposite affect.

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