- About CAQH CORE
- Operating Rules
- New Operating Rule Structure
- Eligibility & Benefits
- Claim Status
- Payment & Remittance
- Prior Authorization & Referrals
- Health Care Claims
- Benefit Enrollment
- Premium Payment
- Mandated Operating Rules
- CORE Certification
- Priority Topics
- Join CAQH CORE
- Resource Library
- CAQH ProView
- CAQH ProView for Groups
- CAQH ProView - Dental
- Provider Directory - DirectAssure
- Credentialing Solutions Suite
- COB Smart
CAQH CORE Participant Calendar
Humana Joins Industry Effort to Improve Provider Data and Directories through CAQH DirectAssure
Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, has joined other national health benefits companies in the effort to improve the accuracy of health care provider directories by participating in CAQH DirectAssure®.
“Our nation’s fragmented approach to maintaining provider directories is undermining the quality of the data and imposing a costly burden on providers,” said CAQH President Robin Thomashauer. “The best way to overcome this challenge is for the industry to work together. The participation of Humana, one of the nation’s largest and most respected health plans, is a leap forward in this effort.”
In recent years, policymakers and other healthcare industry stakeholders have paid increasing attention to the accuracy of health plan directories that members use to find and contact in-network providers, including physicians, hospitals and specialists.
Studies of online directories for Medicare Advantage plans conducted by the Centers for Medicare & Medicaid Services (CMS) found that as much as half of the information contained in network provider directories may be incorrect.
Recent research conducted by CAQH shed new light on one potential cause: The average physician practice updates directory information for 20 health plan contracts, in varying formats and on different schedules for each plan. Although individual health plans have worked to minimize the burden on providers in their network, this fragmented approach taxes physician practice resources and results in errors in the information providers report to the plans.
To address this problem, many of the nation’s leading health plans, such as Humana, are participating in CAQH DirectAssure, which offers a single portal where physician practices can enter, update and verify directory information and share it with all contracted health plans at once.
With a network of more than 425,000 providers nationwide, Humana’s participation in DirectAssure will reduce the burden on physician practices and, over time, contribute to improved directory accuracy for all participating plans. Starting in 2020, Humana will launch CAQH DirectAssure nationwide.
“This partnership with CAQH will help providers save time and money, and at the same time, improve network provider directories, access and convenience for our health plan members,” said Jim Augustus, Humana Vice President of Provider Network Operations. “And it will enable Humana to take a leadership role in improving provider data across our nation’s health care system.”
Learn more about CAQH DirectAssure.
In the news: Ron Urwongse, Director of Strategy and Innovation, did an interview with HealthLeaders Media on how DirectAssure helps to improve provider directories. Read the full interview.