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Better data. Fewer burdens.
CAQH Directory Management helps organizations improve accuracy of provider directories, meet federal requirements, and reduce burdens on staff. The result: improved member access, better network relations and lower health plan costs.

Improve Directory Accuracy and Regulatory Compliance

Health Plan Achieves 84% Directory Accuracy with CAQH

 

The CAQH directory solution draws on the professional and practice information entered by providers in the CAQH Provider Data Portal.  We then use advanced analytics and third party resources to identify and correct potential errors.  

 

Providers are prompted to verify their information in compliance with federal requirements. Health plans then can use this data to identify and correct inaccuracies in their directories.

 

This multi–layered, continuous approach to collecting and confirming directory information is proven and trusted by health plans nationwide.

2.25M
providers rostered
1.79M
confirmed directory profiles
1.72M
providers confirmed information in past 120 days
53
health plans participating in the CAQH Directory Solution

Help members find the practitioner that is right for them

 

 

Provider and Practice Profile

CAQH collects information on health equity, race, ethnicity and language, accessibility to parking and transportation, experience with underserved communities and other factors to help members make informed decisions.

Telehealth

The directory solution includes information on telehealth services available by provider and location, including type of telehealth service, mode of delivery, and type of application/platform.

Network Adequacy

Plans can also use this detailed information to assess, understand and manage their provider networks. 

Reduce Provider Abrasion Through Automation

In the past, health plans relied on postcards, emails, and phone calls to physician practices to obtain and verify directory information.  This process was disruptive to practice staff and yielded poor results.  We automated this process and reduced the need for busy practices to respond to repeated directory-related health plan communications.

Consulting Services: Your partner in continuous improvement

The CAQH Value Consulting team provides hands-on support, technical guidance and best practices to health plans throughout the implementation of directory solutions and beyond.

We will collaborate with your organization to:

 

  • Execute a directory management process tailored to your workflow
  • Collaborate on ways to improve provider engagement, overall data accuracy, and meet regulatory requirements
  • Train and support internal super-users and subject matter experts

 

We provide ongoing support to enable you to identify and act on other opportunities and implement a process of continual improvement.

 

 

Streamline Business Operations

By eliminating the need for costly and labor intensive outreach efforts to collect and confirm directory information, the CAQH directory solution enables plans to save time and money and allocate resources more efficiently.