Symphony Provider Directory launches to streamline provider information reporting

The Integrated Healthcare Association’s (IHA) new Symphony Provider Directory hard-launched last week on January 8, 2019. Back in June 2018, IHA soft-launched the pilot Provider Directory Utility, which has since been re-named.

Funded by a $50 million grant from Blue Shield of California, and tested in collaboration with Anthem Blue Cross and Health Net, the directory looks to address challenges in collecting and reconciling provider information by maintaining a standard platform for plans and providers to compile provider information.  Symphony has been designed to meet the regulatory and business reporting requirements of SB 137, which became law in 2015 and implements penalties for health plans and insurers whose customers who may be responsible for charges for uncovered medical services based on inaccurate directories or coverage information.

 

By standardizing the information collection and reporting process, the California Department of Managed Health Care (DMHC), Blue Shield, and other stakeholders hope to reduce the administrative burden and expense of maintaining accurate provider information while produce more accurate customer-facing information so that consumers can make better decisions about care and coverage.

“We must simplify and standardize our healthcare system in order to transform it,” said Paul Markovich, Blue Shield of California President and CEO. “That includes ensuring essential healthcare provider information is accurate and easy to access. The development of a centralized provider directory utility in California is a strong step in this direction, and one of many investments we have already made or will be making in the future to transform healthcare for all Californians. We are proud to collaborate with IHA to make this happen.”

In the six months of operation since the soft-launch, IHA and its technology partners, Gaine Healthcare and Availity, established baselines for data accuracy and targeted processes to refine the functionality and quality of the platform. Symphony plans to continuously make improvements based on participant feedback as it moves forward to larger network adoption. In a press release about the roll out the organization explains,

“The more plans and providers that participate, the better the data quality and, ultimately, the better equipped consumers will be when making decisions about their coverage and care. Working towards this goal, IHA aims to achieve a critical mass of participation in the Symphony Provider Directory by 2023, including at least 80 percent of plans and providers in California. To encourage participation in the utility, the Symphony Provider Directory will be fully subsidized for health plans and provider groups for the duration of 2019.”

More information on the benefits of the centralize directory and information on joining Symphony can be found here.