Provider Directory Solution Overview

HCAS and our member health plans are pleased to announce an initiative that will increase provider directory accuracy while easing the burden on healthcare providers, who are currently faced with the task of providing updated demographic information to multiple health plans.

The Centers for Medicare & Medicaid Services (CMS), MassHealth, the National Committee for Quality Assurance (NCQA), and provisions of the Affordable Care Act (ACA) include requirements that health plans engage providers in reviewing and maintaining up-to-date provider directory information. The regulations are designed to ensure health care consumers have accurate provider demographic information when accessing health care services. Recognizing that providers face multiple requests for directory information, HCAS and our member health plans are establishing a comprehensive, centralized process to achieve greater efficiency.

HCAS member health plans have selected CAQH® to implement a provider directory solution in Massachusetts and throughout New England. CAQH stood out based upon several factors, including provider familiarity with CAQH’s ProView system, service quality, and CAQH’s willingness to work collaboratively with health plans and providers. The CAQH provider directory solution, DirectAssure®, functions within the current ProView workflow and prompts providers to verify practice location information.

Later this year, health plans will begin implementation work which will take several months to complete. HCAS and its member health plans will continue to share information including project announcements and implementation timelines as they are developed.

Please refer to the resources below for more information on this project, and check back frequently as this page will be updated as new information becomes available.

Directory News

Directory Resources

CAQH Contact Info

  • CAQH: www.caqh.org
  • CAQH Helpdesk: 888-600-9802
  • CAQH email: accounthelp@proview.caqh.org























































 

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