For Providers

The Symphony Provider Directory supports the needs of large provider organizations as well as small independent practices across California. We know that one process does not fit all. No matter how you currently manage provider data, we connect to what works and partner with you to figure out how to streamline what doesn’t.

How Symphony simplifies workflows for provider organizations

• Reduces labor-intensive and manual roster management by automating the data-exchange process
• Allows sharing of data files in any format and translates it for each participating plan

How Symphony simplifies workflows for small independent practices

• Allows you to update information in real-time through a provider portal
• Provides notifications when updates are accepted so you know when the loop is closed

Attestation is currently a painful process that requires a heavy lift from both provider groups and solo practices. The Symphony Provider Directory not only facilitates real-time updates on a routine basis so that quarterly attestation becomes an easy checkpoint, we also enable providers to formally attest for all participating plans in one place.

State and federal policies require that providers periodically validate and attest to the accuracy of the information that health plans share about them with members.

• SB137 requires that health plans outreach to their contracted providers annually and their directly contracted practitioners biannually, to validate, update and attest that their demographic data in the directory is accurate or is not accurate.

• CMS requires that health plans outreach to their contracted providers and practitioners at least quarterly to ensure that their demographic data in the directory is accurate.

Providers who do not attest within the required timeframe may see a delay of payment and/or removal from health plan member directories.

We are working closely with state and federal regulators as they prepare to update and standardize requirements around attestation.

Read more about how Symphony supports providers in achieving compliance for:

• SB 137
• Medicare Advantage
• Medi-Cal

Providers and their staff face a large administrative burden dealing with requests for information from multiple health plans and other organizations. Additionally, keeping track of all the different contractual obligations and other details can be difficult. To help address these challenges, the Symphony Provider Directory:

1. Leverages primary sources by going directly to the source of truth for each data field, such as a signed contract between a plan and a provider or a national database. This is cuts down on provider fatigue and is more effective than calling provider offices directly.
2. Consolidates provider directory updates in one  place, which allows the Symphony Provider Directory to compare data across all participating plans to flag inconsistencies. If nine out of ten plans have the same provider name, it can be assumed with high confidence that the tenth plan is incorrect, unless that plan is the only one using a primary source.
3. Brings transparency to the primary sources and data policies, so we can enable plans and providers to identify and act on inconsistencies (or “bad data”), resulting in improved data quality over time.

Additional resources
Learn about the uniform data standards published by DMHC