A Crisis of Overconfidence
Why Payers’ Provider Data Isn’t as “Clean, Complete, and Centralized” as Leaders Claim
Analyzing a 2025 survey of 150 healthcare executives at enterprise payer organizations
ABSTRACT
While every day is different, most people in the healthcare industry will tell you that there are themes that run throughout their work.
At ProviderTrust, one theme emerges repeatedly with our payer clients: messy, inaccurate, disconnected provider data. So, when our team received the results of a payer-focused survey conducted in partnership with Healthcare Dive in early 2025, we were bewildered to learn that most of the survey’s respondents had a rosy view of their provider network data.
We’d commissioned the survey to strengthen our understanding of how ProviderTrust might better serve payers’ needs for improved provider data integrity. Instead, we learned a different lesson.
Most executives at enterprise-level payer organizations don’t think they have a data problem.
How does the ProviderTrust team know this problem exists? We see the cracks in payers’ provider network data daily, in every department. After receiving the survey results, our team gathered experts from each corner of our business, including product managers, data analysts, implementation specialists, account managers, and sales leaders, to analyze the results. They all said the same thing: How do payers not know there’s a problem?
In this report, we’ll outline the overwhelmingly positive survey results and compare them to our experiences getting up close and personal with the provider data in question. We share this comparison not as an indictment, but as a call for a clearer understanding of the shortcomings that still exist in payers’ provider network data.
Together, we can work towards a better future for healthcare—but only if we all recognize that there’s a problem.
ABOUT THIS SURVEY
This report reflects the results of a survey conducted in March 2025 by Healthcare Dive in partnership with ProviderTrust. The original intent of this survey was to collect and understand pain points that payers experience regarding their provider network data.
SURVEY RESPONDENTS
150 payer leaders who are either “very involved” (51%) or “somewhat involved” (49%) with determining strategy for provider data and operations at their organization.
Results at a Glance
RESULTS VS. REALITY
94% say their provider data is accurate and error-free, but...
12% report receiving "incomplete data" from their third-party provider data vendor.
93% say their provider data is verified against the primary source, but...
Only 47% list state licensing boards among their provider data sources.
97% say their data is connected across departments, but...
Only 13% say data is freely shared between departments on an ongoing basis.
REALITY CHECK 1
To Really Assess Data Integrity, Zoom in Closer
Our survey respondents paint a picture of provider network data that’s complete, clean, accurate, and up-to-date. But when you dig further into this rosy perception, the cracks start to show.
Charting a New Path Forward
It’s time to stop settling for the systems we already have. At ProviderTrust, we don’t claim to have the solution to every problem that payers face. But we’re the best in the industry at solving provider data problems, and we’re here to help solve yours.
Remember the wish list of features that payers wish their solutions had? Simply put, this wish list describes ProviderTrust’s answer to the provider data crisis, a new solution called DynamicNPI®.
DynamicNPI gives payers access to live, verified provider data with just an NPI. Our advanced data mapping strategies connect all the dots between disparate primary sources to bring DynamicNPI users instant visibility into the eligibility of any provider in or out of their network.
We deliver up-to-date primary source verifications, monitor ongoing for federal and state exclusions, and exceed all of NCQA’s updated guidelines for 2025. If you’re ready to create change in your organization, get in touch with the ProviderTrust team today.
The verified provider eligibility data you’ve been looking for.
✔ Meet credentialing and recredentialing verification requirements in mere seconds
✔ Speed up time to credential, expediting the path to revenue
✔ 24/7 access to up-to-date, verified information
✔ Hands-off NCQA-certified automation you can trust
✔ Delivered directly within your workflow of choice with ProviderTrust’s turnkey API
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The verified provider eligibility data you’ve been looking for.
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