Provider Directory Rules Database

PDRules. Provider Directory Requirements, Simplified.

Introducing the Provider Directory Rules Database

PDRules is powered by Link, a BRG DRIVE™ application, and helps health plans to mitigate risk by staying current on provider directory requirements at both the federal and state levels.

Health plans are required to provide and maintain accurate listings of both facilities and physicians that participate in their provider networks. Regulators and enforcement agencies are increasingly taking the view that outdated or inaccurate provider directories potentially prevent enrollees from receiving the care they need. As a result, new regulations and requirements—at the federal and state levels—around provider directories are being developed at an appreciable rate. These requirements often dictate not only what information is to be displayed, but also how current and accessible that information needs to be.

Given this environment, health plans operating in multiple states often find it difficult to stay current on the relevant rules and potentially risk enrollment sanctions, monetary penalties, or more costly litigation.

PDRules is offered on a subscription basis. For further information, please contact:

Brian E. Hoyt

BRG’s Provider Directory Rules database–or “PDRules”–allows health plans to potentially mitigate these risks by aggregating relevant state and federal requirements related to provider directories into one web-based application. PDRules leverages the power and security of BRG’s DRIVE analytics platform to provide powerful yet simple functionality, including:

Easy to Search: Being able to easily locate and review relevant requirements is critical. PDRules users can quickly search by state to view relevant requirements and consolidated insights from knowledgeable BRG healthcare policy experts. Users can also perform global searches using keywords or navigate to relevant requirements using sorted lists.

Current: Reviewing current and up-to-date information is vital. PDRules allows users to stay current and identify new requirements via two primary methods. First, PDRules allows users to track requirements by displaying those that have been posted since their last login. Second, PDRules pushes new posts and information to users and stakeholders via email digests.

Insightful: Engaging in a discussion around these requirements often brings new insights and perspectives. To that end, users can also leverage BRG Insights—a robust and integrated collaboration tool that allows quick sharing of your findings to your organization’s users.

BRG Drive: Provider Directory Rules