MSP Today Expert Feature
September 08, 2016

Doctor Directories in California Get a Boost with New Law


The recent issues around health insurance have been at least somewhat difficult for many to deal with. Just trying to find a policy can be a struggle lasting several weeks, and the issue of finding a doctor that accepts these policies within a reasonable drive can be even worse. Now throw in the idea of having to deal with badly out-of-date or inaccurate information, and you're trying to swim the backstroke with water wings made of concrete. That's an issue California's out to fix with a new law requiring timely updates on the state's directories for doctors.

The new law was authored by state Senator Ed Hernandez, who is actually an optometrist along with his wife Diane. Though the new law resulted in some new paperwork for his own practice, Hernandez likely sees this as an advance all the same. Hernandez chairs the California Senate Health Committee, and put the new law in place as a way to improve provider directories, which are often considered full of inaccurate or otherwise outdated information.

With the new law in place, both insurance companies and healthcare providers need to update the records quarterly to help ensure that any inaccurate information isn't inaccurate for long. Plus, any patients that end up with unexpected bills from the mistakes now have some options to address these. Those who use a directory to find a doctor and visit said doctor, only to discover later that the directory information was invalid and thus out-of-network rates were charged, can now file complaints with a provider and get some of that money back.

So far, the practice is considered welcome and valuable, with the law covering not only every market plan from Covered California and Medi-Cal, but also most insurers that might be obtained privately. It's also proving something of a model to other states who have considered such plans as well, with California's considered the most thorough and wide-reaching in scope.

Inaccurate information is a problem for businesses in every market the world over. It's hard to find something that's universally a problem, but if anything would qualify, inaccurate information would have to be on the list. Whether it's sending bids to the wrong office or going to the wrong doctor, it's a problem everyone has to address. A move like this helps ensure that the information being used is accurate, and that's good news for everybody.

Having the right information means the best decisions can be made. Making the right decisions tends to improve outcomes. This is good news for the state, and likely, for those who follow suit in taking advantage of up-to-date information to make those decisions.




Edited by Alicia Young




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