Provider Directory Health Check

Provider directories are an important part of ensuring member access to appropriate in-network care. However, maintaining accurate directories is an industry-wide challenge that requires a comprehensive strategy, planning, and collaboration.

CAQH works with plans, providers, and industry stakeholders across the country to help improve the provider and member experience relative to directories. This health check helps identify some of the areas that are important considerations for health plans looking to augment their directory approach.

Take the assessment to identify important opportunities for improvement.

Let’s start with you.

Completion time: 5 minutes

Before you begin, tell us a little about your organization.

Do you know how much of your provider network already exists within the CAQH database?

Yes No

Welcome! Take a moment to answer the questions and provide your details in the form. Once you're done, get ready to uncover your personalized questionnaire results.

Question 1/10

Do you leverage existing credentialing data collection workflows to gather up-to-date provider data for directories? Or do you ask providers to submit directory data as a part of new, additional workflow(s)?

Existing Credentialing Data Providers Submit Directory Data Separately

Question 2/10

Does your organization rely mostly on traditional provider outreach methods (phone, fax, mail) or a self-service portal to obtain and manage directory information?

Self-Service Traditional Provider Outreach

Back

Question 3/10

Does your program allow group practice administrators to manage non-sensitive directory information such as locations and phone numbers for multiple providers at one time?

Yes No

Back

Question 4/10

Do you differentiate between a primary location and a secondary location where the clinician does not regularly see patients?

Yes No

Back

Question 5/10

Does your directory solution capture information on diversity-related factors and the patient populations that practitioners serve? (This includes race, ethnicity, gender, LGBTQIA+, and other factors.)

Yes No

Back

Please complete the form below to continue the rest of the check and see your final results.

Question 6/10

Do you capture whether providers offer telehealth services, including information about which telehealth platform the provider uses and the types of services they deliver?

Yes No

Back

Question 7/10

Does your directory provide details about providers offering specialized services and care to help ensure members find the providers that best suit their needs?

Specialty and Specialized Treatment Data General Specialty Data Only

Back

Question 8/10

Does your directory solution prompt providers to review and confirm their information in accordance with federal compliance requirements such as CAA/NSA and state regulations?

Yes No

Back

Question 9/10

Are you able to leverage AI, analytics and third-party data to validate information submitted by providers?

Yes No

Back

Question 10/10

Does your organization have a strategy in place to motivate providers to assume greater responsibility for ensuring data accuracy and timely data validation in accordance with federal and state regulations?

Yes No

Back

You scored a %!

Check out your detailed report!

Report Summary

Organization:

Overall Score:

Top area of focus:

Provider & Member Experience

Question 1: Do you leverage existing credentialing data collection workflows to gather up-to-date provider data for directories? Or do you ask providers to submit directory data as a part of new, additional workflow(s)?