OAKLAND, Calif., March 14, 2024 (GLOBE NEWSWIRE) -- The Integrated Healthcare Association (IHA) and Covered California, the state’s Affordable Care Act health insurance marketplace, have finalized contracts to use IHA’s Symphony Provider Directory data for all Qualified Health Plans. Symphony’s centralized, cloud-based platform will help ensure Covered California’s online provider directory data is accurate and up-to-date, making it easier for consumers to make decisions about their care and health plan coverage. Symphony is expected to go live with Covered California in early 2025.
“Provider directory accuracy is critically important as new members come to Covered California and move between plans,” says Jeff Rideout, MD, MA, FACP, President and CEO of IHA. “However, maintaining accurate provider directories can be a significant and expensive administrative burden for health plans and providers. Symphony alleviates this burden, allowing health plans and providers to easily share, reconcile, and validate data used to populate provider directories.”
Currently, more than 100 large provider organizations, nearly 120,000 smaller provider entities, and 18 health plans and purchasers participate in Symphony. All of the 12 Covered California Qualified Health Plans and provider networks are already actively engaged with Symphony.
Accurate provider directories matter
Launched in 2019, Symphony addresses the regulatory requirements associated with California’s Senate Bill 137. The bill requires health plans to maintain and routinely verify the accuracy of provider directories based on uniform data standards. More recent regulatory activity includes California Assembly Bill 236, Ensuring Accurate Health Plan Provider Directories. Currently in the Senate Appropriations Committee, AB 236 requires health plans to audit and delete inaccurate listings from their provider directories annually and ties existing requirements to accuracy benchmarks, which will serve as an enforcement mechanism.
Meeting these provider directory regulatory requirements is easier said than done. A single doctor might network with a dozen or more health plans and be affiliated with a variety of independent physician associations and hospitals, each with their own health plan contracts. For providers, this makes directories a constantly moving target because each health plan requires different kinds of information and submission formats.
A centralized platform for provider directory data
Symphony unites California health plans and providers around a centralized solution to streamline complex, error-prone data exchange processes, enabling participants to keep their internal systems and public provider directories up-to-date. Symphony currently identifies more than 80,000 corrections to provider directories every 30 days, ensuring health plans can maintain accurate provider directories. Symphony supports over 300 data attributes, and each has a specific data policy that helps determine how data is validated and which value survives as the recommended “golden record.”
Availity, the nation’s largest real-time health information network, is the single-source technology partner for Symphony. Availity Provider Data Management (PDM), a web-based multi-player platform designed for provider information, supports Symphony’s data sharing, reconciliation, and validation for participating health plans, provider organizations, and small provider entities.
“The synergy between Availity and Symphony lies in empowering health plans and providers to exchange information more efficiently and work within standardized business rules and workflows,” said Russ Thomas, CEO of Availity. “With these ongoing improvements, IHA is progressing toward a future where high-value, equitable care is the new standard.”
Learn more about Symphony.
About Integrated Healthcare Association (IHA)
Integrated Healthcare Association (IHA) brings the healthcare community together to solve industry-wide challenges that stand in the way of high-value care. As a non-profit industry association, we use our decades of expertise, objective data, and unique role as a trusted facilitator to make the healthcare system work better for everyone. We provide insights that help the healthcare system continuously improve. We build new tools that simplify how the industry works together. And we provide a forum for cross-industry leaders - through our boards and programs - to have honest conversations that guide the future of healthcare.
About Availity
Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange among health plans, providers, and technology partners. As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Our suite of dynamic products, built on a powerful, intelligent platform, enables real-time collaboration for success in a competitive, value-based care environment. For more information, including an online demonstration, please visit www.availity.com or call 1.800.AVAILITY (282.4548). Follow us on LinkedIn and Twitter.
