--- title: "Eliminating Ghost Networks: Improve Provider Network Directories | Valenz Health" description: Learn how Valenz Health is working to eliminate healthcare ghost networks with industry-leading data cleaning and validation methodologies. image: https://blog.valenzhealth.com/hubfs/eliminating-ghost-networks.png --- [Skip to content](https://blog.valenzhealth.com/healthcare-ghost-networks#page-content) [![Valenz Health](https://blog.valenzhealth.com/hubfs/web/logo.svg)](https://www.valenzhealth.com/) - [Who We Serve](https://www.valenzhealth.com/who-we-serve/) - [Solutions](https://www.valenzhealth.com/solutions/member-experience/) - [About Us](https://www.valenzhealth.com/about-us/) - [Resources](https://www.valenzhealth.com/resources/) - [Contact](https://www.valenzhealth.com/contact/) ### [Patients](https://www.valenzhealth.com/who-we-serve/members/) ### Payers - [Employers](https://www.valenzhealth.com/who-we-serve/employers/) - [Taft-Hartley Funds](https://www.valenzhealth.com/who-we-serve/taft-hartley-funds/) ### Providers - [Healthcare Facilities and Providers](https://www.valenzhealth.com/who-we-serve/healthcare-facilities-and-providers/) ### Plans - [Health Plans](https://www.valenzhealth.com/who-we-serve/health-plans/) - [Third-Party Administrators](https://www.valenzhealth.com/who-we-serve/third-party-administrators-tpas/) - [Brokers and Consultants](https://www.valenzhealth.com/who-we-serve/brokers/) - [Stop Loss Producers](https://www.valenzhealth.com/who-we-serve/stop-loss-producers/) #### Partner with Us Discover how Vālenz Health® can simplify the healthcare experience with our innovative solutions. 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[ValenzONE](https://www.valenzhealth.com/solutions/plan-performance/valenz-one/) Back ### Search [![Arrow Left](https://blog.valenzhealth.com/hubfs/web/Icon-Arrow-Slate-Left-Union.svg)Back](https://blog.valenzhealth.com/) # Eliminating Ghost Networks: How Vālenz Health® is Redefining Provider Network Directories November 13, 2025 | By: [Vālenz Health®](https://blog.valenzhealth.com/healthcare-ghost-networks#vālenz-health®) ![](https://blog.valenzhealth.com/hs-fs/hubfs/eliminating-ghost-networks.png?width=375&height=375&name=eliminating-ghost-networks.png) The recent news that Cigna has agreed to [a $5.7 million settlement](https://www.beckerspayer.com/legal/cigna-oks-5-7m-settlement-in-ghost-network-lawsuit/) in a class-action “ghost network” lawsuit underscores what many in the healthcare industry have known for years:  When provider network directories aren’t accurate, plan payers and members are the ones left paying the price. While many have accepted data inconsistencies as inevitable, Vālenz Health® is transforming the process to deliver higher levels of accuracy for all.  In today’s blog post, we dive into the true cost of so-called “ghost directories” in the healthcare system, why they keep happening, and how Valenz is leading the industry in eliminating them — helping payers, plans, and providers move forward with clarity, control, and confidence to deliver smarter, better, faster healthcare for all. ## What is a Ghost Network in Healthcare? In healthcare, a “ghost network” refers to any provider directory or network that lists providers or facilities that are inaccurately displayed, unreachable, or out-of-network — a situation that is, unfortunately, all too common today.  According to one study published in [the Journal of American Medical Association](https://jamanetwork.com/journals/jama/fullarticle/2802329#248925202), 81% of provider networks reviewed in 2023 had inconsistencies or errors. Recent reports reflect the same trend: An October 2025 study from the Office of Inspector General revealed that [up to 99.2% of behavioral health listings](https://oig.hhs.gov/documents/evaluation/11233/OEI-02-23-00540.pdf) in Medicare Advantage or Medicaid plans are “ghost” listings.  The frequency of ghost networks stems from the very design of the modern healthcare system. Today, stakeholders across the healthcare journey — patients, payers, providers, and plans — are increasingly disconnected. As a result, providers and plans do not maintain the degree of communication needed to update their networks when changes are made to coverages, addresses, and facility or provider names, among other things.  To make it even more challenging, no single source of truth exists within the healthcare industry. Many plans must maintain their own provider networks using files provided to them, files which often conflict, lack standardization, and contain errors or inaccuracies due to the sheer volume of information they include.   Understanding the lifecycle of provider data shows that cross-validation across multiple sources is essential to establish a reliable source of truth. However, many plans do not fully understand the scope of the problem, fail to act until penalties are imposed, and often lack the internal systems needed for thorough cleansing, validation, and maintenance of provider data.  As a result, despite their well-known consequences, “ghost networks” continue to plague today’s healthcare system. ## Ghost Networks: One More Challenge in Today’s Complicated Healthcare Ecosystem Ghost networks aren’t just inconvenient from a data perspective. They also exacerbate the existing challenges plan members face when trying to schedule much-needed care.   [Americans frequently cite](https://www.cdc.gov/nchs/data/nhsr/nhsr207.pdf) “difficulty finding a doctor, clinic, or hospital that \[will\] accept their health insurance” as a barrier to care. When plan members cannot trust the accuracy of their insurance provider networks, finding care becomes that much more challenging. Using outdated information, they may mistakenly seek care from out-of-network providers, increasing their own out-of-pocket expenses.  Those who go the extra step to confirm coverage beforehand often experience heightened frustration when their time and effort is wasted contacting providers who are no longer in network, no longer in service, or not accepting any new patients. As a result, some may end up delaying or giving up on finding care altogether — [adding fuel to the existing delayed care fire impacting health outcomes](https://pubmed.ncbi.nlm.nih.gov/39595468/).   The negative effects aren’t limited to plan members, either.  Ghost networks place a very real legal and financial threat on health plans, which are required by [No Surprises Act regulations](https://www.valenzhealth.com/resources/no-surprises-act/) to verify and update provider directories [at least every 90 days](https://www.ama-assn.org/system/files/2020-12/no-surprises-act-summary.pdf). Large health plans are now paying the price for non-compliance, as demonstrated in [Cigna’s recently settled lawsuit](https://www.beckerspayer.com/legal/cigna-oks-5-7m-settlement-in-ghost-network-lawsuit/).  In addition to these legal risks, ghost networks place an administrative burden on healthcare plans in the form of claim denials and appeals, increased out-of-network spend, and member dissatisfaction with plan coverage.  ## How Vālenz Health® Eliminates Ghost Networks with Data Cleansing and Matching  As it becomes clear that old methods of provider directory maintenance no longer meet the demands of today’s healthcare system, Valenz has developed [an industry-leading data cleansing and matching strategy](https://blog.valenzhealth.com/healthcare-provider-data-management) to eliminate ghost networks for our clients.  Using our proprietary, behind-the scenes logic, we analyze provider information present in our extensive dataset, including years of robust claims data from clients across thousands of network files. As a result, we can cross-validate with a level of confidence that those limited to a single plan or network cannot, delivering higher accuracy than other provider directories in the industry.  The provider data landscape is constantly evolving, requiring proactive models, advanced automation, and modern technology to stay ahead. Recognizing that need, Valenz combines proprietary data assets, AI-driven validation, automated quality sweeps, and API integrations to catch errors and inaccuracies early, often before they surface in the first place.  By uniting these capabilities, we identify discrepancies in near real-time and implement updates quickly to keep plans and members accurately informed.  As an added step, to further meet our clients’ needs, we combine all of this information into one, easy-to-use, industry-leading search tool: **Valenz Provider Directory.** **![valenz-bluebook-provider-directory](https://blog.valenzhealth.com/hs-fs/hubfs/Blog/Blog%20Graphics/valenz-bluebook-provider-directory.png?width=1500&height=1058&name=valenz-bluebook-provider-directory.png)** With Provider Directory, [a feature of our Valenz Bluebook solution](https://www.valenzhealth.com/solutions/member-experience/valenz-bluebook/), health plan members not only gain access to the latest, validated network data for their care needs. They also receive transparent cost and quality data that meets No Surprises Act requirements and directs them to high-value, low-cost care options to fit their needs — delivering an average savings of **$1,500 per procedure**.  The result: Fewer ghost networks, higher member satisfaction, superior care outcomes, and smarter, better, faster healthcare for all involved.  ## Improve Member Experience with Cleaner, Accurate Provider Network Directories Today  Despite its perception as an industry filled with red tape, the healthcare ecosystem can move fast — and health plans need a data validation team that can keep up with those frequent changes and updates.  Otherwise, they open themselves (and their members) up to substantial risks, including significant wasted time, energy, and money.  With the industry-leading data cleansing and validation support offered by Valenz, health plans can greatly reduce the occurrence of “ghost networks” and the consequences associated with them.   Even better? By combining our Provider Directory with our other [industry-leading Member Experience solutions](https://www.valenzhealth.com/solutions/member-experience/), health plans can improve the entire member journey, from start to finish — directing plan participants to the highest-value providers and facilities that are in-network, deliver good care outcomes, and cost significantly less for both member and plan payers.  To learn more about how our data validation processes can help your plan optimize the utilization of high-value healthcare for its members, connect with our network data experts below.  ### Connect With Us to Learn More ![Vālenz Health®](https://blog.valenzhealth.com/hs-fs/hubfs/Valenz%20Logo%20Signature.png?width=180&name=Valenz%20Logo%20Signature.png) ## Vālenz Health® Vālenz Health® is the platform to simplify healthcare — the destination for patients, payers, providers, and plans to reduce costs, improve quality, and elevate the healthcare experience. 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