Calls to the MPS patient referral service amply illustrate that many Maryland insurers have inflated provider directory lists, resulting in a complicated, arduous effort for policy holders to access their insurance coverage for mental health treatment. We receive calls practically daily from frustrated, even tearful, patients calling down the list, getting turned down many times (“our doctors just see inpatients,” “she doesn’t come here anymore,” etc.).  Payer directories look like there are enough providers, but there are not.  Exposing this deception and requiring that provider directories reflect reality would force payers to be more conciliatory to providers to entice them to participate by reducing red tape, paying faster and paying at market prices.

EVEN IF YOU DO NOT PARTICIPATE, look in the provider directory for the Maryland insurance exchange created under the Affordable Care Act (ACA) to see if you are listed. The Maryland Health Connection Provider Directory allows you to search by name, by location, or by the type of provider. People are using this directory search to decide what plans to sign up for under ACA. The Maryland exchange states, “Search results show the health plans your provider participates in to help you choose the right coverage for you.” It also includes the disclaimer, “The provider directory is based on information submitted by each health plan…”

The direct link to the provider directory is: https://providersearch.crisphealth.org. If you don’t find your name, try just your last name and click Search. The directory can be persnickety about spelling, so you can also click Advanced Search and enter Psychiatry and to look through all the psychiatrists listed. The FAQs state that inaccurate information on providers should be emailed to providersearch@crisphealth.org.

CRISP is working to improve the accuracy of the directory, which will help everyone in the long run.  The ACA requires the exchanges to indicate whether the provider is accepting new patients so your participation is encouraged.  Here is what some psychiatrists have found after looking themselves up:

•  “…listed on the Exchange but incorrect office location. Listed with 17 products. Only participate with 4…”
• “…listed at two locations and 26 products. Only one of the locations is correct, and none should be listed as I am not accepting outpatients at this location…”
• “#1 – It listed me as being a provider for Dominion Dental Services; #2 – the location that they list … shut down Child Psych. Services in 2006 #3 – …listed under Psychiatry and not Pediatric Psychiatry. I have not been paneled under any insurance since 2005.”
• “I am not listed, but I saw names of colleagues that I know have moved out of state.”
• “I am listed as being in 17 plans but I have not been in any plan for 11 years.”