Key members on the Senate Finance Committee introduced a bill titled the Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act. The bill comes after the Committee convened a hearing to explore solutions for a mounting problem: ghost networks. There’s nothing paranormal about the issue, but for huge numbers of patients seeking care, ghost networks can turn into a nightmarish hassle. The name is spooky, but the cause is both mundane and entrenched.
What is a ghost network?
A ghost network is a health insurance directory which features multiple providers who cannot meet the needs of the patients they purport to serve. Barriers to care in ghost networks can include listing providers who are out of network or not accepting new patients. Even entries for doctors who do meet patients’ needs and may not display the correct contact information or location. Ultimately, ghost networks cause consumers to believe their coverage is more comprehensive than it is.
The problem extends nationwide, as the Senate’s inquiry proved. In 2022, Blue Cross Blue Shield of Illinois came under scrutiny after patients reported navigating dead-end directories while trying to schedule treatments and regular care. Researchers found that significant numbers of the doctors listed in BCBSIL’s directories were not available, not taking new patients, located too far away or not working at all. In 2021, the city of San Diego sued three major insurance providers for false advertising, asserting that Molina Healthcare, Kaiser Permanente and Centene’s Health Net misled consumers by maintaining inaccurate provider directories. The suit alleged that between 35 percent and 80 percent of doctors in these directories were false, out of date or incomplete. At the time of the filing, the three insurers served more than a million patients in California.
Ghost networks do not exist on Zocdoc.
We are proud that ghost networks do not exist on Zocdoc, for one simple reason: Zocdoc incentivizes providers to maintain accurate information. Providers pay a new patient booking fee each time a new patient books an appointment through our marketplace. This creates a simple but powerful motivation to accurately advertise their practice to prospective patients. Zocdoc also invests in the quality of our directories: When a provider joins the marketplace, we help them accurately list all their accepted insurances as part of the onboarding process. We maintain regular touchpoints with providers thereafter to ensure that their information stays accurate.
In the wider network of insurance providers, there is no efficient system to update a stagnant document at the scale and volume required. By contrast, Zocdoc’s marketplace evolves by the minute, while others may become out of date the moment a listing is published. Providers regularly engage with their Zocdoc account to update insurance information, visit reasons, specialty, availability and more.
Zocdoc also dedicates an entire team to maintaining the accuracy of this information. That means if a patient reports errors in a provider’s listing, we can quickly follow up with the practice to address the discrepancy.
A provider’s time is valuable, as is each appointment booking. Our provider partners are rewarded with more bookings for presenting patients with the most accurate and relevant information about their practice.
When patients experience true transparency from their health care providers, they’re empowered to make informed choices about their care. We remain committed to building tools to get us there.
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