Pilot Program Underscores Need to Contract as an Urgent Care Center

A pilot program aimed at making it easier to keep insurers’ provider directories up to date could benefit urgent care entities that contract as such—and make it harder for those that don’t to draw patients. The six-month program, sponsored by America’s Health Insurance Plans (AHIP), will offer more than 100,000 providers in California, Indiana, and Florida the luxury of informing just one point of contact about any changes in their practice instead of having to contact each insurer individually. Once changes are entered into a centralized database, the information will be shared with participating plans; consumers will have direct access, as well. Too often, directories fall out of date, leading to patients unknowingly going to out-of-network providers. The pilot highlights the importance of urgent care centers establishing urgent care contracts: when patients search their directory for in-network providers, practices that have contracted specifically as urgent care providers will be listed as such. Those that do not will likely be listed as primary care, and ignored by any patients who were looking for urgent care centers specifically. Anthem, Cigna, and Humana are among the dozen health plans taking part in the pilot, which will run from April through September of this year. AHIP plans to recommend best practices for data reporting and accuracy at the end of the pilot.