Directory Maintenance Solution Reduces Administrative Burden for Provider Groups

Directory Maintenance Solution Reduces Administrative Burden for Provider Groups

CAQH, HealthCare Administrative Solutions (HCAS), and its member health plans are implementing new technology to improve directory information used by consumers to find care providers.

CAQH and HCAS collaborated closely with health plans, provider groups and stakeholder associations in New England to enhance CAQH’s directory maintenance tool, DirectAssure, to enable large provider groups to submit directory data to health plans more efficiently.

“By bringing health plans and providers together, we were able to align around a common solution that everyone involved felt comfortable adopting,” said Sorin Davis, senior vice president of industry relations at CAQH.

Several health plans in the region have been working collaboratively to adopt DirectAssure for directory maintenance. DirectAssure uses data from ProView, CAQH's self-reported provider data solution. Once health plans begin using DirectAssure, provider groups can send directory data to all DirectAssure-participating health plans from within the ProView portal.

Because provider groups often already use ProView to send credentialing information, the process of sharing directory data is seamless. Some providers have already begun submitting directory information through ProView.

A new feature in the ProView practice manager portal enables practice managers to update the location information for multiple providers sharing the same location at one time. With this feature, providers will no longer need to change this information in the individual ProView profiles, and practice managers can send directory updates to health plans without a provider attestation (although an attestation will still be required to approve credentialing information).

“This process, once fully implemented, will streamline the data submission process for providers and result in more accurate directory information for consumers. HCAS and its health plans worked together with CAQH to create the solution, and provider organizations will experience the benefits,” said Lori Burgiel, executive director at HCAS.

About CAQH

CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients, and health plans. Visit www.caqh.org and follow us on Twitter: @caqh.

About HCAS

HealthCare Administrative Solutions, Inc. (HCAS) is a non-profit entity founded in 2005 for Massachusetts health plans to collaborate on administrative simplification initiatives designed to increase efficiency and reduce healthcare administrative costs.