What is the impact of provider directory accuracy on member costs and access?

• A. It has no effect on costs.
• B. Inaccurate directories can mislead members about access and costs; accuracy helps determine network-based cost expectations.
• C. It only affects hospital access.
• D. It determines premium amounts.

Answer: (B)

The main idea here is that provider directory accuracy directly affects how easily members can access care and what they’ll pay. When directories reliably show which providers are in-network, their locations, and the services covered, members can accurately estimate network-based costs and choose providers accordingly. If the directory is inaccurate, members may think a provider is in-network and expect certain costs, only to encounter higher charges or balance bills because the provider isn’t actually in-network or the services listed aren’t covered. Conversely, an accurate directory helps members anticipate what their plan will pay and what their out-of-pocket costs will be.

This isn’t about premiums, which are set by plan pricing and actuarial factors, not directory accuracy. It also isn’t limited to hospital access—any in-network provider, not just hospitals, affects access and costs. So, keeping provider directories accurate is essential for guiding members to the right providers and giving them reliable cost expectations.