DirectAssure https://www.caqh.org/ en Real-World Methods for Improving Provider Directory Accuracy https://www.caqh.org/about/event/real-world-methods-improving-provider-directory-accuracy <span>Real-World Methods for Improving Provider Directory Accuracy </span> <span><span lang="" about="/users/mnewcaqhorg" typeof="schema:Person" property="schema:name" datatype="">mnew@caqh.org</span></span> <span>Fri, 09/06/2019 - 09:50</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2019-09-17T18:30:00Z">September 17, 2019 | 02:30 PM EDT</time> - <time datetime="2019-09-17T19:30:00Z">September 17, 2019 | 03:30 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>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.<br /> Join the conversation as we highlight how DirectAssure<sup>®</sup>:</p> <ul><li>Improved a health plan's overall provider response rate of 84 percent. </li> <li>Identified 40 percent of its existing practice locations as invalid. </li> </ul><p><strong>Resources:</strong></p> <ul><li><a href="http://go.caqh.org/l/339361/2019-09-17/6kgvj">Presentation Recording</a> </li> </ul></div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/real-world-methods-improving-provider-directory-accuracy" data-a2a-title="Real-World Methods for Improving Provider Directory Accuracy "><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> Fri, 06 Sep 2019 13:50:03 +0000 mnew@caqh.org 2523 at https://www.caqh.org Easing Access to Provider Directory Data https://www.caqh.org/about/newsletter/2019/easing-access-provider-directory-data <span>Easing Access to Provider Directory Data</span> <span><span lang="" about="/users/mwoolstoncaqhorg" typeof="schema:Person" property="schema:name" datatype="">mwoolston@caqh.org</span></span> <span>Thu, 05/30/2019 - 08:54</span> <div class="field field--name-field-subtitle field--type-text-long field--label-hidden field--item"><h2><p>Integrated portal creates seamless transition between two CAQH Solutions</p> </h2></div> <div class="field field--name-field-display-date field--type-timestamp field--label-hidden field--item">May 2019</div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>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 <a href="https://www.caqh.org/solutions/directassure">DirectAssure</a> and <a href="https://www.caqh.org/solutions/caqh-proview">CAQH ProView</a>.</p> <p>Touching more than 1.5 million health plan-provider relationships, DirectAssure is supporting directory accuracy for a large portion of Americans. Participating organizations will now have enhanced capabilities to simplify provider look-up, roster management, as well as basic and on-demand reporting.</p> <p>This year, CAQH plans to add additional enhancements to the new DirectAssure portal that focus on value-added reporting.</p> </div> <div class="field field--name-field-taxonomy-type field--type-entity-reference field--label-inline"> <div class="field--label">Type</div> <div class="field--item"><a href="/type/article" hreflang="en">Article</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> Thu, 30 May 2019 12:54:04 +0000 mwoolston@caqh.org 2382 at https://www.caqh.org Ease Directory Maintenance and Sprint to the Safe Zone for Your CMS Audit https://www.caqh.org/about/event/ease-directory-maintenance-and-sprint-safe-zone-your-cms-audit <span>Ease Directory Maintenance and Sprint to the Safe Zone for Your CMS Audit</span> <span><span lang="" about="/users/cmassiecaqhorg" typeof="schema:Person" property="schema:name" datatype="">cmassie@caqh.org</span></span> <span>Wed, 10/03/2018 - 15:44</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2018-10-16T19:00:00Z">October 16, 2018 | 03:00 PM EDT</time> - <time datetime="2018-10-16T20:00:00Z">October 16, 2018 | 04:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><a href="http://go.caqh.org/l/339361/2018-10-03/49258i">Join</a> 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.<br /><br /><strong>Webinar Highlights:</strong></p> <ul><li>Discover how DirectAssure is designed to emphasize the most essential practice location directory data.</li> <li>Review early results from UnitedHealthCare participating in the solution.</li> <li>Learn best practices for DirectAssure implementation and for integrating DirectAssure into your provider data management process.</li> </ul><h4>Resource: <a href="http://go.caqh.org/l/339361/2018-10-23/4g76n">Presentation Recording</a></h4> </div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/ease-directory-maintenance-and-sprint-safe-zone-your-cms-audit" data-a2a-title="Ease Directory Maintenance and Sprint to the Safe Zone for Your CMS Audit"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> Wed, 03 Oct 2018 19:44:44 +0000 cmassie@caqh.org 2227 at https://www.caqh.org Massachusetts Health Plans Select DirectAssure to Improve Provider Directory Accuracy https://www.caqh.org/about/newsletter/2018/massachusetts-health-plans-select-directassure-improve-provider-directory <span>Massachusetts Health Plans Select DirectAssure to Improve Provider Directory Accuracy</span> <span><span lang="" about="/users/cmassiecaqhorg" typeof="schema:Person" property="schema:name" datatype="">cmassie@caqh.org</span></span> <span>Mon, 09/10/2018 - 09:25</span> <div class="field field--name-field-display-date field--type-timestamp field--label-hidden field--item">September 2018</div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><a href="http://www.hcasma.org/">HealthCare Administrative Solutions</a> (HCAS), a non-profit organization of Massachusetts-based health plans, has chosen <a href="http://www.directassure.org/">DirectAssure</a><sup>®</sup> after an extensive search for a solution to improve healthcare provider directories in the state.</p> <p>With DirectAssure, providers enter their directory information changes once and share them with multiple plans. The solution works in concert with <a href="https://www.caqh.org/solutions/caqh-proview">CAQH ProView</a><sup>®</sup>, 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.<!--break--></p> <p>“CAQH offers an existing solution that minimizes the administrative burden of provider data collection and already has unmatched provider engagement in New England,” said Lori Burgiel, Executive Director, HCAS.</p> <p>Over the coming months, HCAS member health plans and CAQH will educate the local provider community on the solution and the data sharing opportunities it offers.</p> <p>Learn more about this partnership <strong><u><a href="https://www.caqh.org/about/press-release/massachusetts-health-plans-select-caqh-solution-increase-provider-directory">here</a></u></strong>.</p> </div> <div class="field field--name-field-taxonomy-type field--type-entity-reference field--label-inline"> <div class="field--label">Type</div> <div class="field--item"><a href="/type/article" hreflang="en">Article</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> Mon, 10 Sep 2018 13:25:36 +0000 cmassie@caqh.org 2209 at https://www.caqh.org Plan Achieves 84% Accurate Directory https://www.caqh.org/about/event/plan-achieves-84-accurate-directory <span>Plan Achieves 84% Accurate Directory</span> <span><span lang="" about="/users/cmassiecaqhorg" typeof="schema:Person" property="schema:name" datatype="">cmassie@caqh.org</span></span> <span>Mon, 07/09/2018 - 09:52</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2018-07-19T19:00:00Z">July 19, 2018 | 03:00 PM EDT</time> - <time datetime="2018-07-19T20:00:00Z">July 19, 2018 | 04:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>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. <br /><br /> In this webinar, learn how DirectAssure<sup>®</sup>, the CAQH Solution to improve provider directory quality, simplified the health plan’s outreach process.<br /><br /> Results include:</p> <ul><li>84% accurate directory data.</li> <li>Reduced CMS audit vulnerability.</li> <li>Improved member satisfaction.</li> <li>Decreased provider abrasion and operational costs.</li> </ul><h4>Resource: <a href="http://go.caqh.org/l/339361/2018-07-20/3wmpn">Presentation Recording</a></h4> </div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/plan-achieves-84-accurate-directory" data-a2a-title="Plan Achieves 84% Accurate Directory"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> Mon, 09 Jul 2018 13:52:20 +0000 cmassie@caqh.org 2168 at https://www.caqh.org The Hidden Cost of Calls https://www.caqh.org/about/event/hidden-cost-calls <span>The Hidden Cost of Calls</span> <span><span lang="" about="/users/cmassiecaqhorg" typeof="schema:Person" property="schema:name" datatype="">cmassie@caqh.org</span></span> <span>Tue, 06/05/2018 - 14:21</span> <div class="field field--name-field-subtitle field--type-text-long field--label-hidden field--item"><h2><p>The Midday Download, brought to you by CAQH</p> </h2></div> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2018-06-12T17:00:00Z">June 12, 2018 | 01:00 PM EDT</time> - <time datetime="2018-06-12T18:00:00Z">June 12, 2018 | 02:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Improving the quality of provider directories is resource-intensive and expensive. <br />  <br /> Gain insight into the potential ramifications of common provider outreach methods many health plans use today.<br />  <br /> Join CAQH Product Management staff Hassaan Sohail and Ron Urwongse for a <strong>20-minute discussion highlighting how a health plan improved the quality of data in its directory while deprioritizing phone outreach and minimizing provider abrasion. </strong></p> <p><strong>Resource: <a href="http://go.caqh.org/l/339361/2018-06-15/3q84m">Presentation Recording</a></strong></p> </div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/hidden-cost-calls" data-a2a-title="The Hidden Cost of Calls"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> Tue, 05 Jun 2018 18:21:49 +0000 cmassie@caqh.org 2146 at https://www.caqh.org Data Quality Improves with DirectAssure Enhancements https://www.caqh.org/about/newsletter/2018/data-quality-improves-directassure-enhancements <span>Data Quality Improves with DirectAssure Enhancements </span> <span><span lang="" about="/users/mnewcaqhorg" typeof="schema:Person" property="schema:name" datatype="">mnew@caqh.org</span></span> <span>Wed, 03/28/2018 - 10:49</span> <div class="field field--name-field-display-date field--type-timestamp field--label-hidden field--item">March 2018</div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>In its second year of adoption, <a href="http://www.directassure.org/">DirectAssure</a> 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.</p> <p><!--break--></p> <p>Three new features released in late 2017 are improving data quality. The first feature, which resulted in an immediate 15-percent increase in accuracy, involved identifying and suppressing inaccurate practice locations – the most common error in Centers for Medicare and Medicaid Services (CMS) audits of directories. The feature presents providers with a series of questions to confirm that practice phone numbers can be used for scheduling appointments and that providers regularly treat patients, and take appointments, at the locations listed. In only five months, DirectAssure identified one million locations that should be suppressed in directories.</p> <p>The second feature reconciles information discrepancies between plans and providers. Plan directory data in DirectAssure is now compared to CAQH ProView provider profiles, and differences are presented to the provider to accept or amend. Corrections are applied to the profile and made available to participating plans. Recent audit results for one large health plan demonstrated a 35-percent increase in location accuracy.</p> <p>The third feature enables providers to easily confirm that they are participating with a health plan and accepting new patients covered by that plan. Plans use this data to address misalignment between contract terms and provider responses, and update their directories.</p> <p>Learn more about these and other DirectAssure features in an on-demand <a href="http://go.caqh.org/l/339361/2017-10-26/6k2d">webinar featuring Cigna-HealthSpring</a>.</p> </div> <div class="field field--name-field-taxonomy-type field--type-entity-reference field--label-inline"> <div class="field--label">Type</div> <div class="field--item"><a href="/type/article" hreflang="en">Article</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> Wed, 28 Mar 2018 14:49:12 +0000 mnew@caqh.org 2111 at https://www.caqh.org Provider Directories: Moving Beyond the Blame Game https://www.caqh.org/about/event/provider-directories-moving-beyond-blame-game <span>Provider Directories: Moving Beyond the Blame Game</span> <span><span lang="" about="/users/cmassiecaqhorg" typeof="schema:Person" property="schema:name" datatype="">cmassie@caqh.org</span></span> <span>Fri, 03/23/2018 - 14:06</span> <div class="field field--name-field-subtitle field--type-text-long field--label-hidden field--item"><h2><p>The Midday Download, brought to you by CAQH</p> </h2></div> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2018-03-27T17:00:00Z">March 27, 2018 | 01:00 PM EDT</time> - <time datetime="2018-03-27T17:20:00Z">March 27, 2018 | 01:20 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Improving the accuracy of provider directories has been a reoccurring challenge for health plans and providers alike, but ultimately who is responsible? <br /><br /> 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. <br /><br /><strong>Join our industry experts for a 20-minute informal webinar</strong>, as they discuss the root causes for poor quality provider data, preferred methods for data collection, and how to bridge the gap between the health plan and providers to eliminate data latency and to improve the accuracy of data being submitted.</p> <h4>Resource: <a href="http://go.caqh.org/l/339361/2018-03-26/2tbc7">Recording</a></h4> </div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/provider-directories-moving-beyond-blame-game" data-a2a-title="Provider Directories: Moving Beyond the Blame Game"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> Fri, 23 Mar 2018 18:06:45 +0000 cmassie@caqh.org 2102 at https://www.caqh.org Share Directory Updates with CAQH ProView https://www.caqh.org/solutions/share-directory-updates-caqh-proview <span>Share Directory Updates with CAQH ProView</span> <span><span lang="" about="/users/mwoolstoncaqhorg" typeof="schema:Person" property="schema:name" datatype="">mwoolston@caqh.org</span></span> <span>Wed, 01/03/2018 - 10:26</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><h4>Take the Frustration out of Updating Directories</h4> <p>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. </p> <table border="1" cellpadding="1" cellspacing="1" color="gray" style="width:600px; color:gray"><tbody><tr><td> <h4><span style="font-size:16px;"><strong><a href="/solutions/caqh-provider-directory-data-confirmation-solution-participating-organizations">Health plans</a> already using CAQH ProView to update directories include:</strong></span></h4> <ul><li>Blue Cross Blue Shield of Arizona</li> <li>Care1st Health Plan of Arizona</li> <li>CareFirst BlueCross BlueShield</li> <li>CIGNA HealthSpring</li> <li>Health Alliance Plan</li> <li>HealthNow NY</li> <li>Horizon Blue Cross Blue Shield</li> <li>Medical Mutual of Ohio</li> <li>Meridian Health Plan</li> <li>Priority Health Plan</li> <li>United Healthcare<sup>®</sup></li> </ul></td> </tr></tbody></table><h4>Why maintain your directory information in CAQH ProView?</h4> <div class="long-list-text"> <ul><li>The CAQH ProView 'Directory Snapshot' makes it easy to review and update directory changes at any time.</li> <li>Use a single process to share directory changes with multiple health plans.</li> <li>Reduce the number of requests you are receiving for directory information from your network health plans.</li> <li>Leverage your CAQH ProView profile to simplify directory maintenance, not just credentialing.</li> </ul></div> <h5> </h5> <h5>Featured Resources</h5> <div class="long-list-text"> <ul><li><strong><a href="/sites/default/files/solutions/directassure/directory-maintenance-provider-fact-sheet.pdf">Fact Sheet</a></strong>: Take the Frustration out of Updating Directories.</li> <li><strong><a href="/sites/default/files/solutions/directassure/directory-best-practices-checklist.pdf">Best Practices Checklist</a></strong>: Are your patients getting correct directory information?</li> <li><strong><a href="/sites/default/files/solutions/directassure/guide-to-submitting-directory-changes.pdf">Guide</a></strong>: Submitting Directory Changes in CAQH ProView.</li> <li><strong><a href="/sites/default/files/solutions/directassure/directory-maintenance-template-letter-to-health-plans.docx">Template Letter to Health Plans</a></strong> Requesting Use of CAQH ProView for Directory Maintenance.</li> </ul></div> </div> <div class="field field--name-field-taxonomy-type field--type-entity-reference field--label-inline"> <div class="field--label">Type</div> <div class="field--item"><a href="/type/article" hreflang="en">Article</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/healthcare-providers" hreflang="en">Healthcare providers</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> Wed, 03 Jan 2018 15:26:35 +0000 mwoolston@caqh.org 2069 at https://www.caqh.org Health Plan Strategies to Improve Directory Accuracy https://www.caqh.org/about/newsletter/2017/health-plan-strategies-improve-directory-accuracy <span>Health Plan Strategies to Improve Directory Accuracy</span> <span><span lang="" about="/users/mnewcaqhorg" typeof="schema:Person" property="schema:name" datatype="">mnew@caqh.org</span></span> <span>Mon, 12/18/2017 - 14:20</span> <div class="field field--name-field-display-date field--type-timestamp field--label-hidden field--item">December 2017</div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>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.</p> <p>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. </p> <p>These efforts have resulted in provider practices fielding outreach from multiple health plans, all seeking the same information, and increasing the burden on practice staff. The outreach also requires a high-level of health plan resources.</p> <p>To address these challenges, CAQH launched DirectAssure last year, which leverages data from CAQH ProView for accurate directory maintenance. CAQH conducts outreach to providers aligned with regulatory reporting requirements prompting them to review, update and attest to their practice information. When they update that data, it can then be shared with all participating health plans that have the provider in their network.</p> <p>Location accuracy remains a particular challenge. In its 2017 report, CMS found that at least 45 percent of the locations reported in directories are incorrect. Most often this can be attributed to the provider not actually practicing at the published location.</p> <p>CAQH has recently enhanced the functionality in DirectAssure to address the location challenge and better enable health plans to meet regulatory requirements. New location-specific questions ask providers to accept or reject location information, and require a reason for rejections. The responses are sent to participating health plans which can then reconcile any discrepancies.</p> <p>A number of health plans are now using DirectAssure as part of their directory maintenance strategy. In a recent webinar with CAQH, Cigna-HealthSpring reported a 20 percent increase in data accuracy since January 2016. To learn more about their efforts to manage provider directories, <a href="http://go.caqh.org/l/339361/2017-10-26/6k2d">download the webinar</a>.</p> <ul><li>Learn more about DirectAssure at <a href="http://www.directassure.org/">www.directassure.org</a>.</li> <li>Learn more about CAQH efforts to improve the quality of provider data for healthcare stakeholders and patients at <a href="http://www.caqhproviderdata.org/">www.caqhproviderdata.org</a>. </li> </ul></div> <div class="field field--name-field-taxonomy-type field--type-entity-reference field--label-inline"> <div class="field--label">Type</div> <div class="field--item"><a href="/type/article" hreflang="en">Article</a></div> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-organization-type field--type-entity-reference field--label-inline"> <div class="field--label">Organization Type</div> <div class="field--item"><a href="/organization/health-plans" hreflang="en">Health plans</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/directassure" hreflang="en">DirectAssure</a></div> </div> Mon, 18 Dec 2017 19:20:29 +0000 mnew@caqh.org 2061 at https://www.caqh.org