Ghost networks: what skipping provider directory verification costs
A new JAMA study found errors in more than half of mental health directory calls. What that costs practices, and how to make verification less painful.
Why does directory verification feel like busywork?
Every practice manager knows the routine. Each contracted plan sends its own directory verification request, on its own schedule and through its own portal, and the same address, phone number and panel status get confirmed over and over. CAQH (now DataSpring) attestations run on a separate 120-day cycle. For a small group with a dozen payer contracts, keeping up can eat hours every quarter, and the work rarely seems to change anything. Credentialing companies managing hundreds of providers carry that burden many times over.
What happens when directory data is wrong?
A study by Simon Haeder and colleagues, published October 16, 2026 in JAMA Health Forum, isn't encouraging if you're the one answering these requests. Researchers placed 5,822 secret shopper calls to psychiatrists and psychologists listed in the directories of the largest commercial carrier in each of five states (Delaware, Montana, New Jersey, Rhode Island and Virginia). Among calls with a definitive result, more than half hit a directory error such as a wrong phone number or incorrect specialty, and about 11 percent reached a disconnected number. Only 12.4 percent of all initial calls produced an appointment. The authors concluded that the No Surprises Act's 90-day verification requirement has not fixed the problem and recommended that regulators shift to audit-based enforcement.
| Finding | Result |
|---|---|
| Calls placed | 5,822 |
| Directory errors, among calls with a clear outcome | 55.6% |
| Disconnected or out-of-service numbers, among calls with a clear outcome | 11.4% |
| Appointment from a single call, among all calls | 12.4% |
| Average wait for an appointment | 20.5 days |
Researchers call these ghost networks, directories full of clinicians patients can't actually reach. Mental health is where the problem has been studied most.
For a practice, each of those failed calls is a patient who wanted to schedule and ended up somewhere else. The authors also note that listed clinicians often take the reputational hit for directory errors they do not control.
I've seen more than one client devote little to no resources to directory verification and not realize payer websites were showing patients outdated contact information for their providers.
Expect more of this. DataSpring's new directory accuracy standard and CMS's proposed 90-day checks for Medicare Advantage plans are both aimed at the same problem.
How can practices make verification less painful?
Verification gets a lot easier when your provider data is already right. That starts with one maintained source of truth for each provider's locations, phone numbers, specialties, taxonomy codes and new patient status, kept current in CAQH and pushed to payers whenever something changes instead of only when a request arrives.
- Assign clear ownership for roster updates.
- Use payer bulk roster submissions where they are available.
- Keep a record of each attestation in case a plan's data is ever disputed.
For credentialing companies, directory maintenance is a natural service to add, and it becomes more valuable if regulators start auditing directories directly.
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About the author
Tony Kuka · Founder, Ziurta
Tony is the founder of Ziurta, a provider enrollment platform for medical practices, health systems, RCM firms, and credentialing companies. He has 30 years in healthcare administration, including 20 building outsourced revenue cycle companies, and founded and sold Medical Business Office and National Credentialing Solutions. He is based in Chattanooga, Tennessee.