Harvard Pilgrim Health Care Home
  HPHConnect
 
  Learn more.
  Sign up for HPHConnect.
Medical Management
E-Transactions
HPHConnect
Pharmacy
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Newsroom
Office Support
Products
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
 
Print    Text Size

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.

Email this article to a colleague   


Network Matters Archives

Download printer-friendly version

HPHCURRENT EVENTS

Medicare Advantage: Expansion and New Benefits for 2019

CAQH Solution Chosen to Improve Provider Directory Accuracy

Introducing Maine POS and HMO Open Access Plans

SaveOn Program Now Called Reduce My Costs

CLINICIAN CORNER

Updates to Antiemetic Therapy Medical Review Criteria

Updates to Molecular Genetic Testing Clinical Guidelines

Synagis for Upcoming RSV Season

OFFICE ASSISTANT

Hospital-Based Clinic and Treatment Room Commercial Payment Policy Updates

2019 CPT and HCPCS codes

Update to Filing Limit for Replacement Claims

PUBLICATION INFORMATION

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator