Humana Joins Industry Efforts to Improve Provider Data and Directories with CAQH DirectAssure

WASHINGTON, February 18, 2020 /PRNewswire/ — CAQHan industry alliance working to transform the healthcare sector, announced today that Humana inc. (NYSE: HUM), one of the nation’s leading health and wellness companies, has joined other national health benefit companies in an effort to improve the accuracy of provider directories. health care by participating in CAQH DirectAssure®.

“Our nation’s fragmented approach to managing vendor directories compromises data quality and places a costly burden on vendors,” said President of the CAQH Robin Thomashaus. “The best way to overcome this challenge is for the industry to work together. The participation of Humana, one of the nation’s largest and most respected health plans, is a leap forward in this effort.”

In recent years, policy makers and others in the health sector have paid increasing attention to the accuracy of the health plan directories that members use to find and contact network providers, including physicians, hospitals and specialists.

Studies of online directories for Medicare Advantage plans conducted by the Centers for Medicare & Medicaid Services (CMS) found that up to half of the information in network provider directories may be incorrect.

Recent research conducted by the CAQH Shedding new light on a potential cause: The average physician practice updates directory information for 20 health plan contracts, in varying formats and at different times for each plan. Although individual health plans have worked to minimize the burden on providers in their network, this fragmented approach taxes medical practice resources and results in errors in the information providers report to plans.

To address this issue, many of the nation’s leading health plans, such as Humana, participate in CAQH DirectAssure, which provides a single portal where medical practices can enter, update, and verify directory information and share it with everyone. contracted health plans at a time.

With a network of more than 425,000 providers nationwide, Humana’s participation in DirectAssure will reduce the burden on medical practices and, over time, help improve directory accuracy for all participating plans. Starting in 2020, Humana will launch CAQH DirectAssure nationwide.

“This partnership with CAQH will help providers save time and money, and at the same time, improve network provider directories, access and convenience for our health plan members,” said jim august, Humana Vice President of Vendor Network Operations. “And it will allow Humana to play a leadership role in improving provider data across our country’s healthcare system.”

Learn more about CAQH DirectAssure.

About the CAQH
CAQH is the leader in creating initiatives to streamline the healthcare industry. Through collaboration and innovation, CAQH accelerates the transformation of business processes, bringing value to providers, patients and health plans. To visit and follow us on Twitter: @caqh.

About Humana
Humana Inc. is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in delivering care and administering health plans helps us create a new kind of integrated care with the power to improve health and well-being and reduce costs. Our efforts lead to a better quality of life for people on Medicare, families, individuals, military personnel and communities at large.

We do this by supporting physicians and other healthcare professionals in their efforts to provide the right care in the right place to their patients, our members. Our range of clinical capabilities, resources and tools – such as home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a streamlined experience that makes healthcare easier to navigate and more efficient.

Further information about Humana is available to investors through the Investor Relations page of the company’s website at www.humana.comincluding copies of:

  • Annual reports to shareholders
  • Filings with the Securities and Exchange Commission
  • Most Recent Presentations at the Investor Conference
  • Press releases and conference calls on quarterly results
  • Event calendar
  • Information on corporate governance


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