Chronos measures the temporal integrity of Medicaid provider directories — auditing the gap between what plans claim and what patients can actually reach. We don't issue confidence scores. We produce names.
A cross-reference of one Washington Apple Health plan's behavioral-health directory against federal claims and state licensure. Public data. Reproducible. Provider-level.
Chronos cross-references every provider against federal claims and state license registries, and dispatches surgical live verification for the survivors. The output isn't a probability — it's a list of names with dispositions.
Cross-reference every directory listing against federal Medicaid claims. Providers with no billing activity in the audit year are flagged inactive.
Verify flagged providers against state license registries. Separates licensed-but-not-billing (phantom) from unverifiable (true ghost).
Automated voice agents call surviving providers to confirm appointment availability, panel status, and wait times. Surgical — not mass outreach. Layer in active build-out; first deployment in our next state engagement.
The 2025 Medicaid Managed Care Access Final Rule mandates independent state directory-accuracy testing of every MCO. 90% compliance required on directory accuracy and wait-time standards. Behavioral health faces a 10-business-day max wait.
| Date | Action | Exposure |
|---|---|---|
| JUL 2027 | Final Rule deadline · MCO directory-accuracy testing90% threshold · per state · per MCO | DEADLINE |
| OCT 2025 | HHS OIG: 55% of MA BH directory inactiveNational federal benchmark | PUBLIC |
| 2025 | California — Health Net directory settlementDirectory inaccuracy enforcement | $40.0M |
| 2026 | Carelon / Elevance — SDNY class actionActive ghost network litigation | ACTIVE |
| POST-2024 | EBSA parity enforcement letters (MHPAEA)120+ letters dispatched | $550K / VIOL |
| 2023 | NY AG — EmblemHealth BH ghost network86% BH ghost rate · precedent | $2.5M |
Medicaid MCOs across 42 states face directory-accuracy testing under the 2027 Final Rule. Chronos gives compliance and network teams provider-level ghost and phantom flags — plus the recruitment list of licensed-but-inactive providers in their service area.
Every state administering Medicaid managed care must independently verify its MCOs. Chronos gives agencies a cross-MCO oversight view: which plans have the worst phantom access, where behavioral-health parity gaps are widest, which networks need intervention first.
A directory can pass time-and-distance adequacy and still be 78% inaccurate at the member level. Chronos measures the thing regulators are about to start measuring.
| NPI | Provider | City | Network status | Last paid claim | Disposition |
|---|---|---|---|---|---|
| 175*****42 | Doe, A. — MD | Seattle | ● In-Network · Accepting | 10/2024 | Verified Active |
| 149*****92 | Doe, B. — PsyD | Seattle | ● In-Network · Accepting | — | Inactive — No Claims 24mo |
| 168*****11 | Doe, C. — LMHC | Tacoma | ● In-Network · Accepting | — | Unreachable — Disconnected |
| 152*****91 | Doe, D. — LCSW | Spokane | ● In-Network · Accepting | 09/2024 | Verified Active |
| 139*****40 | Doe, E. — LMFT | Yakima | ● In-Network · Accepting | — | Inactive — Panel Closed |
| 166*****75 | Doe, F. — MD | Olympia | ● In-Network · Accepting | — | Inactive — No Claims 24mo |
| 124*****63 | Doe, G. — PMHNP | Bellingham | ● In-Network · Accepting | — | Address Mismatch |
| 184*****72 | Doe, H. — PsyD | Seattle | ● In-Network · Accepting | 11/2024 | Verified Active |
| 159*****42 | Doe, I. — LICSW | Tacoma | ● In-Network · Accepting | — | Inactive — No Claims 24mo |
| 170*****74 | Doe, J. — LMHC | Vancouver | ● In-Network · Accepting | — | Inactive — Panel Closed |
In the Washington Apple Health audit: 57% of Primary Care providers were verifiably active for Medicaid. In Behavioral Health, only 22%. A 35-percentage-point gap.
Under the 2024 MHPAEA final rule, network composition is a non-quantitative treatment limitation. A measurable disparity between behavioral health and medical/surgical directory accuracy is parity evidence on its face — exposure of $550K per violation under active federal enforcement.
Chronos runs on any Medicaid directory. First engagement is a defined-scope audit — findings delivered in weeks, not quarters.