Improving Health Plan Provider Directories Q&A
Q&A Navigation:
- Questions about CAQH ProView
- Questions about DirectAssure
- Questions about the No Surprises Act
- Best Practices & Miscellaneous Questions
DirectAssure
Improving Health Plan Provider Directories
More than half of patients use health plan provider directories to find an in-network clinician that is right for them. Despite industry efforts, however, directory inaccuracies have been a persistent challenge. When directory information is incorrect, patients can be inconvenienced and face financial consequences. To address these issues, policymakers at the federal and state levels are requiring health plans and practices to put processes in place to improve provider directory data.
Improving Health Plan Provider Directories
Patients rely on a variety of sources to find the care they need from the clinicians they prefer. These include search engines, doctor rating sites and referrals. Among the more common resources that patients use are health plan provider directories which, according to two surveys conducted in 2020, more than half of patients use to select a physician.
Will You Meet the NSA Directory Requirements in Time?
The No Surprises Act of 2021 takes another step toward mandating that health plans improve the accuracy of their provider directories. The Act includes specific requirements health plans must meet by January 2022. Are you ready? Download the brief to learn more, and request a demonstration today.
Real-World Methods for Improving Provider Directory Accuracy
Health plans nationwide are striving to find cost effective ways to improve the accuracy of provider directories. Learn how CAQH has assisted a health plan in making significant achievements in improving the accuracy of their directories.
Join the conversation as we highlight how DirectAssure®:
- Improved a health plan's overall provider response rate of 84 percent.
- Identified 40 percent of its existing practice locations as invalid.
Resources:
Easing Access to Provider Directory Data
Integrated portal creates seamless transition between two CAQH Solutions
CAQH continues to make progress in improving provider directory data. Most recently, CAQH launched a new portal that streamlines access to provider directory data by integrating DirectAssure and CAQH ProView.
Ease Directory Maintenance and Sprint to the Safe Zone for Your CMS Audit
Join CAQH and Kerith Cain, Director of Provider Data Strategy at UnitedHealthCare, to learn how DirectAssure, the CAQH directory maintenance solution, can provide an immediate boost to the accuracy of your directory information and reduce vulnerabilities for your CMS audit.
Webinar Highlights:
Massachusetts Health Plans Select DirectAssure to Improve Provider Directory Accuracy
HealthCare Administrative Solutions (HCAS), a non-profit organization of Massachusetts-based health plans, has chosen DirectAssure® after an extensive search for a solution to improve healthcare provider directories in the state.
With DirectAssure, providers enter their directory information changes once and share them with multiple plans. The solution works in concert with CAQH ProView®, an online database used by more than 1.4 million providers nationwide to maintain their professional and practice information. DirectAssure asks providers to compare and verify practice location information within health plan records and confirm whether they accept specific insurance plans and if they are accepting new patients.
Plan Achieves 84% Accurate Directory
More than 1.2 million data confirmation calls, continued inaccuracies, and significant provider abrasion were a few reasons why a national health plan explored sustainable approaches to improve the data accuracy of their provider directory.
In this webinar, learn how DirectAssure®, the CAQH Solution to improve provider directory quality, simplified the health plan’s outreach process.
Results include:
The Hidden Cost of Calls
Improving the quality of provider directories is resource-intensive and expensive.
Gain insight into the potential ramifications of common provider outreach methods many health plans use today.
Join CAQH Product Management staff Hassaan Sohail and Ron Urwongse for a 20-minute discussion highlighting how a health plan improved the quality of data in its directory while deprioritizing phone outreach and minimizing provider abrasion.
