A few years ago, I remember making a doctor’s appointment after carefully verifying that the provider was in my insurance network, only to get a bill a few weeks later. Turned out that the good doctor was no longer in my network, but no one bothered to update that information. I had to pay out of pocket. This, despite regulations that require health plans to keep accurate directories of doctors, hospitals and other healthcare providers. 

Earlier this year, the No Surprises Act went into effect to protect patients from such unexpected situations and fine healthcare providers who violate patient billing regulations. That’s all good, but the fact remains that nearly half of provider directories remain inaccurate according to the Centers for Medicare and Medicaid Services. Besides out of network surprises, that includes wrong phone numbers and addresses.

Kevin Krauth, the co-founder of Orderly Health, is trying to solve this persistent problem by helping hospitals, clinics, health plans and others keep their information up to date, and reduce their risk of getting fines. He joins us on Rise of the Next to explain how Orderly Health works behind the scenes to pull the right data.

 

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