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

September 2019

Provider Directory Updates: CAQH Direct Assure Process Launched

Harvard Pilgrim, in collaboration with HealthCare Administrative Solutions, has begun piloting CAQH’s DirectAssure® with a user group of providers.

This approach will enable providers to update their demographic and practice information in one place and share it simultaneously with multiple health plans. 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 and will streamline the process of keeping directory information up to date.

Phased in approach

We are phasing in implementation to support a smooth roll out of this functionality. This tool was successfully piloted in August with a small group of providers and will be rolled out more broadly to several hundred providers in September. To date, we are focused on roll out to providers who directly contract with Harvard Pilgrim, rather than those who are participate in large provider organizations as CAQH is working on developing functionality to best support more complex provider entities.

Pilot users will provide feedback on the system, and we will be working together to confirm that any updates submitted are received and listed accurately in the provider directory.

We will continue to roll this out to other providers in the coming months and will provide additional information about the next phases in future issues of the newsletter.

For more information about the DirectAssure® project, please refer to these resources:

Updating directory information if you aren’t a pilot user

If you are not part of the initial rollout of DirectAssure®, continue to use existing processes to review and report changes to your address, panel status (open or closed) for each individual provider, institutional affiliations, phone number, and other practice data. Please review this information at least quarterly to ensure that patients have access to accurate information to help them in selecting and contacting providers for care.

Notification of address, panel status, and other demographic information changes should be submitted at least 30 days in advance. You may review your practice information via our online Provider Directory. If you need to update any information, please fill out a Provider Change Form and submit it to Harvard Pilgrim’s Provider Processing Center by email at PPC@harvardpilgrim.org.

For any further questions, call the commercial Provider Service Center at 800-708-4414 or the Medicare Advantage Provider Service Center at 888-609-0692.

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Network Matters Archives

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Robert Farias,
Senior Vice President, Corporate Network Strategy

Helen Connaughton,
Director of Network Operations

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator