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®:
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.
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:
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.
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:
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.
In its second year of adoption, DirectAssure has established itself as a leading solution for health plans to address the ongoing challenge of maintaining accurate provider directories. Making changes to directory information is seamless for healthcare providers, who use CAQH ProView to easily review and update their professional information. DirectAssure participating organizations, including most national plans, are already using the solution to manage directory data for more than 800,000 providers. On average, about 600,000 of those providers review and confirm their information every four months, demonstrating a high level of engagement with CAQH.
Improving the accuracy of provider directories has been a reoccurring challenge for health plans and providers alike, but ultimately who is responsible?
Federal and state regulation has directed the accountability for provider directory maintenance to the health plans. Health plans assert that the information they receive from providers is often outdated or incomplete. Conversely, providers contend they are supplying their plans with up-to-date practice information and contract status, but that the data is never used.
Patients want to know your practice locations, whether you are accepting new patients, and if their insurance will be accepted. Use CAQH ProView to make sure your patients get correct directory information.
Improving provider directory accuracy continues to be an industry-wide challenge. Periodic reviews from the Centers for Medicare and Medicaid Services (CMS) have intensified pressure on health plans to improve the quality of directories. Plans allocate significant resources to these efforts, which are a portion of the $2 billion spent annually by the commercial healthcare industry to maintain provider data.
CAQH recently surveyed health plans to learn more about their strategies for improving the quality of directory data. At least half reported being audited since January 2016 when the CMS regulations were announced. Nearly 70 percent of those health plans said they are measuring the accuracy of their directories quarterly or monthly, and in some cases more than once each month. Only 1 out of 5 health plans have experienced significant improvements as a result of their efforts, noting phone, mail and fax outreach were the most effective methods for updating the information.
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