Healthcare providers are increasingly concerned about the effects of “ghost networks” on their costs and efficiency. What exactly is a ghost network, though? Let’s take a closer look at how they work.
Ghost networks, also known as Phantom networks, is a term used by the healthcare industry to describe insurance directories filled with providers who are not clinically active in their indicated specialty or not accepting patients.
The inaccurate or out-of-date information in the directory can cause problems for patients and physicians alike. As a result, we have been working to combat this issue.
“Insurance companies populate their directories with whom they assume are clinically active and treating patients based off of their relationships with the Provider community. However, as we’ve progressed since 2020, providers have relocated – have changed where they’re seeing patients.
We’ve seen as you know, an incredible uptick in telehealth providers and fewer providers in brick-and-mortar locations. Those insurance directories relying on kind of just the traditional paper contracts that have existed, for where providers might be clinically active, are no longer meeting the needs of the ecosystem.
And that’s created this phenomenon of those providers or those networks that we’re getting to hear quite a bit about.”
Jim Brown, SVP of Network Performance, explains in our webinar, Ghost Networks: Are They Haunting You?