Why Rollcall Health exists

Provider directories are required to be accurate and current. Rollcall Health checks what plans actually publish against dated federal records, and is building toward continuous validation of provider network integrity.

By the Rollcall Health research team · 16 August 2026

Every line in a provider directory makes three claims at once. This clinician is real. They are in this network. This is where you reach them. 45 CFR 156.230 obliges a qualified health plan to keep those claims published, accurate and current, and a member picks a plan on the strength of them. When a line is wrong the cost is not a data quality ticket, it is somebody calling a number, being told no, and starting again.

The gaps survive the requirement

The rule is real and so is the effort under it. Plans hire data-quality vendors, providers attest on a cycle, CMS has run its own directory reviews. With all of that in place, our read of 30 August 2026 compared 16.8 million published listings across 104 directories on the CMS federal Marketplace against two federal files and still found 14,463 listings naming an NPI that NPPES records as deactivated and 340 matching an active federal exclusion. The median finding had been published for 327 days, and the oldest for 19.9 years. That is the CMS federal Marketplace, individual medical qualified health plans, and no other programme. The full report sets out coverage and method.

The network is a moving target

None of this is negligence. Providers move, practices close, registrations are cancelled, exclusions land every month, and phone numbers change without anyone filing anything. A file cleaned in January is a different file by March. Every control above runs in rounds, from the plan's own roster, on the plan's schedule, so each round aims at where the network used to be. A periodic process is chasing a continuous one, and the distance between them is measured in stale rows.

Settle what data can settle

Our first layer is a data pipeline, not a phone bank. We read every published directory whole and join every line against the dated federal record: whether the registration is cancelled in NPPES, whether the person appears on the HHS-OIG exclusion list. Both files are public, both carry their own dates, and anyone who downloads them gets the same answer. Each finding is one row the plan can look up before it replies, with no integration, no roster, no claims and no member data. Because the read is a pipeline rather than a project, it runs again as the files change.

Verify the exceptions with AI

Whether the clinician still practises at that address, whether the phone is answered, whether the practice still takes the plan: no registry records any of it. Those are the exceptions, and they take contact. Checking them by hand across a network is the expensive part, which is why it happens as an occasional clean-up. Our research, email and voice agents run that ladder in production: they work the records the data says are most likely stale, put the specific question to the practice, and attach what comes back to the row as dated evidence. What they cannot settle confidently goes to a person, so people judge the hard cases instead of checking every record. How the verification ladder works

The bet we are making

Pipelines settle what a public record can settle, and agents verify the exceptions. Together the two hold a moving target that rounds of manual clean-up cannot, and they can run continuously because reading files and making calls both cost a fraction of what they used to. The end state is a standing check that the network a plan shows its members is the network they can actually use, rather than a directory that was accurate once. That is provider network integrity, and it is what Rollcall Health is built toward.

What a finding is not

A finding does not establish a regulatory violation, a credentialing determination, or proof that anyone was paid. We cannot see claims and we do not guess at them. The claim is deliberately narrow: on this date your published directory carried this registration, and on this date this federal file said this about it. Both halves are dated and reproducible. Plans are not named here. Which plan sits where goes to that plan first, with its own rows, before anything else.