Industry Challenge – Provider Directory Accuracy
The Compliance & Care Crisis
Inaccurate provider directories aren't just a compliance risk – they create a care crisis, preventing members from accessing the right providers, increasing grievances, and exposing payers to costly penalties and reputational damage.
Provider data changes annually.
Directories have errors misleading patients.
CMS fines can go up to $25,000 per beneficiary per day.
State fines can be $10,000 to $100,000 for Non Compliance.
Industry Pain Point
Member Dissatisfaction
Members face incorrect contact details or location information, affecting access to care. This directly damages the Payer reputation and results in increased grievance calls.
VerifiCarePro Solutions
Enhance member satisfaction
VerifiCarePro’s automated provider directory management ensures over 95% data accuracy, reducing incorrect contact or location details. This results in up to a 40% reduction in member grievance calls related to provider information, significantly enhancing member satisfaction and protecting payer reputation.
Industry Pain Point
High Operational and Administrative Costs
Over $2.76 billion annually is spent by health plans and providers just to maintain provider data accuracy. $2.1 billion of this is the administrative burden on health plans alone for outreach, updates, and corrections.
VerifiCarePro Solutions
Enhance Revenue
Over 50% of revenue enhancement by eliminating operational and administrative cost and burden. VerifiCarePro's provider directory management services can save millions annually enabling you to reallocate resources to higher-value member and provider initiatives.
Industry Pain Point
Revenue and Network Impact
Incorrect directory data leads to out-of-network billing disputes and loss of potential member enrollments.
VerifiCarePro Solutions
Enhance your Brand.
VerifiCarePro ensures provider directory data accuracy, reducing out-of-network billing disputes by up to 40%, preventing revenue leakage, and improving network transparency. This enhances member trust and drives higher enrollment rates, directly supporting payer growth and profitability.
Industry Pain Point
Compliance Risk and Penalties
CMS penalties: Up to $25,000 per beneficiary per day. State fines: Between $10,000–$100,000 per infraction.
VerifiCarePro Solutions
Stay compliant
Our verification workflows and quality ensure regulatory compliance with CMS and state directory requirements, reducing the risk of penalties by over 90% and maintaining comprehensive audit readiness at all times.
The True Cost of Inaccurate Directories
Every year, health organizations lose millions due to inaccurate provider data — from operational inefficiencies to patient mistrust. Here's how.
Labor Costs
Annual spend on verification and reprocessing
Member Dissatisfaction
Of members report frustration to inaccurate directories
Out-of-Network Referrals
Annual losses from inaccurate network data
Call Volume Spikes
Triggered by a single inaccurate phone number
Low Trust & Churn
Misinformation leads to lost patients
How VerifiCarePro Works
Get up and running in minutes with our streamlined four-step process designed for healthcare organizations.
Data Integration
Securely connect your existing systems and import provider data with our seamless integration tools.
Data Integration
Securely connect your existing systems and import provider data with our seamless integration tools.
Trusted by Healthcare Leaders
See what healthcare professionals are saying about their experience with VerifiCarePro.
"We struggled with outdated provider information affecting member experience and claims. VerifiCarePro streamlined the entire process, from self-service provider updates to directory publishing. Their support team is responsive, and the implementation was seamless."
- Director of Operations, National Health Plan
"VerifiCarePro has transformed how we manage our provider directory. Earlier, updating provider details took weeks of manual outreach, but now it’s automated and audit-ready within days. Our compliance accuracy improved by over 40%, significantly reducing CMS penalties."
- VP, Provider Network Management (Healthplan in Tampa, FL)
"Maintaining directory accuracy to meet No Surprises Act requirements was a challenge. VerifiCarePro gave us real-time validation tools and automated reminders for providers to update their data. This reduced our administrative burden and ensured regulatory compliance effortlessly."
- Chief Compliance Officer (Vision Plan in Tampa, FL)
"Our call center volumes due to incorrect provider information have gone down significantly since we implemented VerifiCarePro. Members now get accurate provider details online, improving satisfaction scores and reducing operational costs."
- SVP, Member Services
"Argus is passionate about providing value and quality to its members. Accuracy of our provider directory is critical to this mission and to our growing network. VerifiCare has been a tremendous asset through it’s unique focus on improving the quality of our directory."
- Brian Hauser – Senior Vice President Operations – Argus Dental and Vision, Inc.
"We’ve trusted eCosmos with the accuracy of our directory and other business critical functions for over 8 years, and I’m excited to work with VerifiCare as the next evolution in provider data management solutions."
- Sr Vice President of Operations - A Large Medicare Advantage Plan
"We struggled with outdated provider information affecting member experience and claims. VerifiCarePro streamlined the entire process, from self-service provider updates to directory publishing. Their support team is responsive, and the implementation was seamless."
- Director of Operations, National Health Plan
"VerifiCarePro has transformed how we manage our provider directory. Earlier, updating provider details took weeks of manual outreach, but now it’s automated and audit-ready within days. Our compliance accuracy improved by over 40%, significantly reducing CMS penalties."
- VP, Provider Network Management (Healthplan in Tampa, FL)
"Maintaining directory accuracy to meet No Surprises Act requirements was a challenge. VerifiCarePro gave us real-time validation tools and automated reminders for providers to update their data. This reduced our administrative burden and ensured regulatory compliance effortlessly."
- Chief Compliance Officer (Vision Plan in Tampa, FL)
"Our call center volumes due to incorrect provider information have gone down significantly since we implemented VerifiCarePro. Members now get accurate provider details online, improving satisfaction scores and reducing operational costs."
- SVP, Member Services
"Argus is passionate about providing value and quality to its members. Accuracy of our provider directory is critical to this mission and to our growing network. VerifiCare has been a tremendous asset through it’s unique focus on improving the quality of our directory."
- Brian Hauser – Senior Vice President Operations – Argus Dental and Vision, Inc.
"We’ve trusted eCosmos with the accuracy of our directory and other business critical functions for over 8 years, and I’m excited to work with VerifiCare as the next evolution in provider data management solutions."
- Sr Vice President of Operations - A Large Medicare Advantage Plan
Enterprise-Grade Security & Compliance
Your data security is our top priority. VerifiCarePro meets the highest standards for healthcare data protection.
Certifications & Compliance
VerifiCarePro maintains the highest industry certifications and compliance standards.
Our Commitment
At VerifiCarePro and e-Cosmos, we are driven by:
Integrity in data and partnerships
Innovation in solving healthcare’s toughest operational challenges
Impact that improves member experience and payer performance
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Why Choose Us?
- Real-time, validated provider data
- Automated CMS-compliant verification
- Centralized data source
- Eliminate ghost networks
- Reduce manual intervention and costly penalties