The No Surprises Act (NSA) has fundamentally changed how health plans manage provider directories. While much of the attention surrounding the legislation focuses on surprise billing protections, the law also places significant responsibility on health plans to maintain accurate provider information and respond quickly to member inquiries about network participation.
For many organizations, meeting these requirements is easier said than done. Provider data changes constantly, information often resides across multiple systems, and manual processes can make compliance both resource-intensive and difficult to sustain.
As regulatory expectations continue to evolve, health plans need a more efficient approach to provider directory management – one that supports accuracy, transparency, and operational efficiency.
Under the NSA, health plans must ensure provider directory information remains current and accessible to members. When the information is inaccurate, the consequences extend beyond compliance risk. Incomplete or incorrect directory listings may cause members to:
Schedule appointments with providers who are no longer participating in their network
Experience delays in care due to incorrect provider information
Lose confidence in their health plan’s ability to provide reliable information
Submit complaints related to inaccurate network participation data
For health plans, these issues create additional administrative burden, increase call center volume, and may expose the organization to regulatory scrutiny.
The challenge is that provider information is dynamic by nature. Practice locations change, providers join or leave networks, specialties evolve, and affiliations are updated regularly. Maintaining accuracy requires continuous coordination across multiple teams and systems.
As health plans evaluate their readiness for NSA provider directory requirements, it can be helpful to assess the core operational capabilities needed to support compliance. Use the checklist below to identify key obligations, common pain points, and opportunities to strengthen the provider directory management processes.
Update provider directories within two business days
Ensure provider changes are reflected quickly in member-facing directories
Manual reconciliation slows updates across systems
Streamlines provider data workflows supporting faster directory publishing/updates?
Outdated directory information damages trust and creates compliance exposure
Improves provider data quality and visibility into potential issues
Retain records and support audit readiness
Offers reporting and visibility into provider data changes and directory management activities
Automates key directory management workflows to reduce administrative burden
Coordinate upstream provider data sources
While the NSA introduced new compliance requirements, it also presents an opportunity for health plans to strengthen provider data management practices.
Organizations that invest in accurate, reliable provider directories can reduce administrative burden, improve member experiences, and enhance trust in their networks.
By combining strong provider data governance with purpose-built directory management technology, health plans can move beyond simply meeting compliance requirements and create a more efficient, member-centered approach to provider information management.
Provider directory inaccuracies continue to impact health plans across the industry. Organizations that can deliver accurate, accessible provider information have an opportunity to stand apart. By improving member trust and reducing barriers to care, provider directory excellence becomes more than just a regulatory obligation—it becomes a competitive differentiator and a foundational component of delivering a better healthcare experience.
Whether you’re managing compliance requirements or improving access and workflows, symplr Directory helps you maintain accurate provider data across your organization without the manual burden.
