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How Do the No Surprises Act Requirements Affect Compliance with Provider Directories?

The No Surprises Act requirements go into effect in 2022.


Section 116 of the No Surprises Act, “Protecting patients and improving the accuracy of provider directory information,” seeks to safeguard patients from relying on incorrect provider data that can lead to surprise medical bills.

The No Surprises Act will directly affect all payers and providers who will need to assess their compliance procedures related to provider directories and information verification.

Here is what you need to know about how the No Surprises Act requirements affect compliance with provider directories:

  1. Every 90 days, payers must verify providers’ information and providers must assist with this process by submitting regular updates.

  2. When providers make changes to their information, online provider directories must be updated within 48 hours.

  3. Providers whose information is unverified will be removed from online provider directories.


Essentially, providers will need to maintain their information with payers on about a quarterly basis beginning in 2022 or risk removal from online provider directories and lose the marketing presence that these directories provide when patients search for in-network providers online.


The No Surprises Act requirements will help keep provider information current and improve the accuracy of provider directories. However, if you’re doing credentialing work yourself, these changes will require you and your staff to commit even more time and attention to credentialing and compliance.

EligibilityOne can handle these time-consuming tasks for you. We offer credentialing and compliance services, including:

  1. Updating payers and provider directories with providers’ data.

  2. Monitoring providers’ expirables (CE credits, licenses, certifications, insurance, etc.) so they don’t miss renewal deadlines.

  3. CAQH registration.

  4. Health plan audits.

  5. And much more.

We can even build a custom maintenance and monitoring program that works best for your providers and practice.

Providers and payers need to prepare now for the new rules that begin in 2022.

Contact us today to put a plan in place that will ensure you and your providers comply with the No Surprises Act requirements, avoid removal from provider directories, and set the foundation for a successful new year!


By Stephanie Salmich


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