- 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
DirectAssure for Health Plans
CAQH Provider Directory Data Confirmation Solution
Developed in collaboration with health plans, DirectAssure uses a subset of the CAQH ProView data that health plans now use for credentialing.
- More than 1.6 million providers are already familiar with CAQH ProView.
- Using DirectAssure to review, update and validate provider data is easy and convenient.
DirectAssure reduces the extraordinary number of requests providers receive from each health plan to update their directory information. The one-to-many solution enables providers to update their information once and share it with all participating health plans they authorize to receive their information. This process eliminates the need for outreach to providers from every plan with which they contract.
CAQH emails reminders, on at least a quarterly basis, to select providers on behalf of participating health plans to review their directory information. Those who do not respond are contacted by phone and mail. Providers log in to the solution, review their information, make any necessary updates and then confirm that the directory information can be published. The confirmation is time stamped, and a snapshot of information is taken for audit purposes.
This directory data confirmation complements the usual CAQH ProView attestation process that providers are familiar with for credentialing purposes, making the experience seamless.
DirectAssure also – through the streamlined provider outreach – helps improve the quality of the self-reported data used for credentialing.
DirectAssure is the industry’s best choice:
- Trustworthy – Leverages existing long-standing relationships with providers.
- Compliant – Helps plans meet federal and state requirements, and avoid costly penalties for noncompliance.
- Robust – Already contains self-reported data for more than 1.6 million providers who know how to use CAQH ProView.
- Timesaving – Dramatically reduces the frequency of provider outreach.
- Cost effective – One-to-many approach in a secure, shared solution that benefits all.
- Forward Thinking – Built on a scalable and flexible technology platform to accommodate growing healthcare industry needs for provider data.
- Medicare Advantage 2016 Call Letter
- CMS Memo to Medicare Advantage Plans(November 13, 2015)
- HHS Notice of Benefit and Payment 2016
- Medicaid and CHIP Proposed Rule
- NCQA Health Plan Accreditation 2016 Proposed Updates
- Proven Strategies for Improving Provider Directory Accuracy. Learn how from UnitedHealthcare and CAQH. [Slides]