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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

October 2018

CAQH Solution Chosen to Improve Provider Directory Accuracy

As a member plan in HealthCare Administrative Solutions (HCAS), Harvard Pilgrim is participating in efforts to institute a centralized process for providers to review their demographic data and report changes to ensure provider directory accuracy. We are pleased to announce that an important milestone has been reached: HCAS has selected a vendor for this work — DirectAssure®, a CAQH Solution.

We anticipate that the DirectAssure® business solution will allow Harvard Pilgrim and other HCAS health plans to maintain more accurate provider directories while easing the burden on healthcare providers, who currently must update their demographic information individually with each plan. Because DirectAssure® works in concert with CAQH ProView, an online database that most providers already use to regularly review and attest to professional and practice information, this approach capitalizes on an existing workflow.

As you know, patients rely on directories for information that guides them in choosing a provider that’s right for them and for assistance in contacting provider offices. Inaccurate provider directory information is not only a source of frustration for patients, but also a barrier to receiving good health care. Recognizing this, several government and regulatory agencies, including CMS, MassHealth, and the National Committee for Quality Assurance, have developed requirements that health plans maintain accurate provider directory data. By offering providers a more efficient means of updating directory information, this centralized approach will help improve the accuracy of directories.

Harvard Pilgrim will be working closely with our provider partners on this effort in the coming months — discussing implementation and timing, training needs, and answering your questions.

For more information, including a copy of the announcement press release and an FAQ, please refer to the following websites:

We’ll also continue to share updates in future issues of the newsletter.

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