Fix my business listings — for a health practice, that means two systems, not one

If you run a dental office, a chiropractic practice, an optometry clinic, a PT studio or an independent primary care practice, and you have ever typed fix my business listings into a search bar, you probably had Google in mind.

Google is half of it. It is the half that gets written about, because it is the half that is the same for every local business on earth.

The other half is a directory you are legally the source of, that your patients use more often than they use Google, and that most practices have never opened.

The two systems

System one is discovery. Google Business Profile, Apple Maps, Yelp, Bing, and the data aggregators that quietly feed all of them. This is where a stranger with no insurance context finds you. It is the system every “fix your listings” article is about.

System two is eligibility. A patient with a plan does not start at Google. They open their insurer — the app, the member site, the number on the card — go to find a doctor, filter to in-network, and call. Google appears nowhere in that path.

That second directory is not the insurer’s invention about you. Federal law makes you its source. 42 U.S.C. §300gg-139 requires providers and facilities to “have in place business processes to ensure the timely provision of” provider directory information, and to submit that information to a plan at minimum when the provider “begins a network agreement,” when the provider “terminates a network agreement,” “when there are material changes to the content of provider directory information,” and at any other time the plan asks.

Material changes. A new suite number. A phone system swap. A doctor who left. Closing your panel to new patients. Each of those is yours to report, and until you do, the directory keeps telling patients the old thing.

And alongside it there is NPPES — the NPI Registry — which is free, public, needs no account, and carries its own deadline. CMS’s own NPI fact sheet states that “you must report any changes to the information provided for your NPI within 30 days of the change.”

One honest note, because this is the kind of article that usually ends in a threat: we are not going to tell you what the penalty is. We could not find a documented penalty to point you at, so we are not inventing one. What is documented is the duty and the deadline.

What happened when somebody actually checked

CMS did not take the industry’s word for it. It called the directories.

In the third round of its Online Provider Directory Review — a review that ran between November 2017 and July 2018 — CMS reported that “Of the 10,504 locations reviewed, 48.74% (5,120) of the locations had at least one deficiency,” across a total of 5,602 providers.

It published every deficiency type with a count — 5,271 deficiencies in total, which is higher than the 5,120 bad locations because many locations were wrong about more than one thing:

Deficiency type (CMS’s own label)	Count	Share
Provider should not be listed in the directory at this location	2,088	39.61%
Provider should not be listed at any of the directory-indicated locations	1,393	26.43%
Phone number needs to be updated	690	13.09%
Address needs to be updated	364	6.91%
Address (suite number) needs to be updated	239	4.53%
Provider IS accepting new patients	235	4.46%
Provider is NOT accepting new patients	221	4.19%
Specialty needs to be updated	24	0.46%
Provider name needs to be updated	17	0.32%
Total	5,271	100%

The top two categories are the surprise. Together they are 66% of every deficiency CMS found, and both of them say the same thing: the provider was not there. Not a typo in a phone number — a patient driving to an address, or calling a practice, that has nothing to do with that provider.

Two caveats, and they matter more than the headline:

That review is eight years old. CMS published three rounds and we could not locate a fourth. So this is the most recent figure that exists, and it is from 2018. We are not claiming the rate today is 48.74%. Nobody knows the rate today.
It is Medicare Advantage specifically — the population CMS has the authority to audit. It is not evidence about commercial plans.

What the number is genuinely good for is ending one argument: whether this is a real operational problem or something a marketing company made up to sell you a service. CMS dialled ten and a half thousand provider locations and found that about half of them were wrong about something.

The field that costs the most

Of those four categories, one behaves differently from the others.

A wrong phone number loses the patients who try to call. A wrong suite number loses the patients who try to arrive. Both are bad, and both are recoverable — the patient is already looking at you.

Accepting new patients is not like that. It is a filter, not a detail — and CMS counted it wrong in both directions, as two separate categories.

221 listings said a provider was accepting new patients when they were not. That wastes a patient’s afternoon and costs the practice an awkward phone call.

235 — the larger of the two — said a provider was not accepting new patients when they were. Those are 235 practices with open doors, switched off in the directory. They were not compared unfavourably to the practice down the road; they were removed from the list before the comparison happened. The patient never saw the name, so the practice never found out, and nothing in its own analytics would ever show the loss.

It is a single switch, set to whatever somebody last told the plan, and it is the highest-leverage field in healthcare’s listing problem.

The Google rule that only healthcare has

Now back to system one — because healthcare has a structural problem on Google that no other local business has, and it is not caused by anyone being sloppy. It is caused by the rule.

From Google’s own practitioner guidelines, for a location with more than one practitioner:

“The organization should create a Business Profile for this location, separate from that of the practitioner.”

And:

“The title of the Business Profile for the practitioner should include only the name of the practitioner.”

Read it again if you have partners. A three-doctor practice is expected to run four profiles — one for the organization, one for each practitioner — and the practitioners’ profiles are not permitted to carry the practice’s name in the title.

In practice, that produces one of three states, and almost every multi-practitioner practice is in one of them:

One profile, three invisible doctors. Patients searching a doctor’s name by referral find nothing.
Four profiles, three abandoned. Wrong hours, wrong phone, no photos, no posts, on profiles nobody has opened since setup.
Mis-titled profiles — Dr. Somebody at Somewhere Family Dental — which breaks the naming rule and can be reported by anyone, including a competitor.

For solo practices, which is most practices, the guidelines give a different format: a practitioner who is the only public-facing practitioner at a location under a brand should share one profile with the organization, named “[brand/company]: [practitioner name].” One profile, not two. If you have two, you created a duplicate by following your instinct instead of the rule.

Four lookups, fifteen minutes, nothing to buy

Do these yourself. In this order. Nothing here requires a tool, an agency or a card.

1 · The NPI Registry. Go to npiregistry.cms.hhs.gov, search your practice, open the record. Check the practice location address including the suite, the practice location phone, and the last-updated date. The last-updated date usually tells you the whole story before you read anything else.

2 · Your own plan listings. One plan at a time. Find yourself the way a patient would — search your specialty and your city, not your name. Check the phone, the address, and accepting new patients. If a plan’s directory is behind a member login, you are a contracted provider, so use your provider portal instead.

3 · Google, including every partner by name. Search the practice name. Then search each practitioner’s name separately. Write down what actually exists — how many profiles, what each one is titled, what hours and phone each one carries. Not what you remember configuring.

4 · The phone numbers, in a column. Put the NPI Registry number, each plan directory number, each Google profile number and your website’s number side by side. Then call every one of them from your mobile. The one that is not answered by someone who works for you is the first thing to fix — and in our experience with other kinds of local business, it is usually a line set up for something that has since ended.

Where we come in, and where we do not

We do system one. The Presence Fix is $349, one time. Corrections across the major discovery surfaces prioritised by impact starting with Google and the data aggregators, one confirmed-correct business record applied consistently, duplicate handling, removal requests for auto-generated junk pages, proof of each fix showing the corrected listing live, a written status record, and a 30-day re-check.

It is deliberately honest about what platforms allow. In its own words: “Where a platform supports merging, we merge. Where it doesn’t — Apple currently documents no route for merging duplicate pins — we claim the correct listing, correct it, report the duplicate, and tell you it’s outstanding rather than calling it done.”

We do not do system two. We do not file provider directory updates with your payers and we do not touch your NPI record. That work belongs to you, your practice manager or your billing service. We are saying so here, in the page that is trying to sell you something, because the alternative is you paying for a listings service and walking away believing the directory your insured patients actually use has been handled. It has not been.

If you would rather start by looking than by buying, the free Presence Audit is an 8-page workbook with four scored sections and a prioritised fix list. It covers system one. It costs nothing, and it will tell you whether there is anything here worth paying for.

Zipline Creative is in Rochester, NY. The four lookups above are the first thing we run on any business, including our own — where, at the time of writing, our Google Business Profile is categorised as “Branding agency” rather than local marketing, carries no phone number and no hours, and has not had a photo added in 848 days, against 330 total profile views. We publish that because a listings article written by someone with an 848-day-old profile should say so.