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Anthem is trying to solve the "ghost provider" problem by telling doctors and other health care providers to update their provider network entries.
The Elevance subsidiary recently put directory update reminders in news feeds aimed at in-network providers in California and Virginia.
"We understand that keeping your information updated can be challenging," Anthem told California providers. "But it's crucial."
Updating directory entries, including the part about whether a provider is accepting new patients from a plan, "is a contractual requirement with Anthem," Anthem said. "If this critical information is not updated regularly, it can cause discrepancies and misunderstandings about your availability for new patients."
Anthem told providers in Virginia that, starting Jan. 1, 2026, it will leave a provider out of its provider directories if a provider has not confirmed that its directory entry is accurate within the past 90 days.
"Each unique address must be attested," Anthem told the Virginia providers. "Verify the phone and fax numbers, in addition to the practice email address."
What it means: If Anthem's provider directory update push works, employers may find that health plan networks work better.
Workers and other health plan participants may be more likely to get preventive care and the recommended follow-up care because they have an easier time finding doctors who will take their health coverage.
The backdrop: Federal law requires health plans to update their provider directories every 90 days.
But the Pennsylvania Department of Insurance found that 62% of the inaccurate directory entries identified by "secret shoppers" in 2022 were still inaccurate in 2024.
Officials at the U.S. Department of Health and Human Services Office of the Inspector General recently reported that only three of the 356 behavioral health providers listed in one plan's directory were actually taking new patients from that plan.
Plaintiffs' lawyers have taken note of the provider directory accuracy problem and have been suing plans over "ghost provider" allegations.
Members of Congress and other federal policymakers have talked about solving the problem by having Medicare set up and manage a national provider directory.
One obstacle is that many providers believe that any government-run national provider directory would simply create a new provider directory update chore, not eliminate many of their existing provider directory update jobs.
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