Your provider directory may advertise claims payment addresses for practice locations

How can you be certain you are collecting the correct information?

Collecting and confirming provider data is a time-consuming and costly venture.

Providers are inundated with requests from payers for updated practice information while attempting to balance treating patients and juggling other administrative concerns. For some providers it all comes down to ensuring they are reimbursed in a timely fashion, this is why they will often default to using their claims reimbursement address in every ask for contact or practice information.

The directory data management services at CAQH simplifies the practice data collection process by enabling practitioners to update their directory information once and share it with all participating health plans authorized to receive the data.

Providers are presented with directory-related questions. Users are also shown previously captured practice location data to update, confirm or discard. This reduces the likelihood of receiving a claims reimbursement address if it is not also used for seeing patients.


Figure 1:  Previously captured practice  locations for confirmation

Figure 1: Previously captured practice locations for confirmation


This multilayered, bi-directional data validation approach ensures high data accuracy and quality, while reducing the likelihood of receiving a claims reimbursement address if it is not also used for seeing patients.

To assist healthcare organizations in meeting The Consolidated Appropriations/No Surprises Act, 2021, the solution circulates emails to providers every 90-days encouraging them to update, submit and confirm their practice information. The date in which the provider practice location was last updated and confirmed is captured and catalogued for health plans and providers in case proof of outreach and updates are needed.

Figure 2:  Active Practice Location Details

Figure 2: Active Practice Location Details


For more information on how the directory data management services at CAQH can assist your team in collecting accurate provider practice information for use in your provider directory contact a member of our Directory Management Services team at the information below.

Use this link to schedule a free demonstration of the solution.


Schedule A Demo

Audience
Organization Type
CAQH Program
Status