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Provider Data Action Alliance To Improve Healthcare Provider Data


A CAQH commissioned coalition of healthcare leaders has started work in an effort to improve provider data accuracy for both patients and industry stakeholders.

CAQH, the not-for-profit alliance of health plans and networks, has charged the Provider Data Action Alliance to develop a roadmap to include both vision and strategies to obtain and share better information. Participants in the Alliance include:

  • Health plans
  • Dental plans
  • Vision plans
  • Provider organizations
  • Health systems
  • Government organizations

You can view the roster of Alliance members on their website.

Inaccurate provider information is all too common, despite the importance of accurate data in healthcare processes such as provider directories and paying claims. A recent Centers for Medicare & Medicaid Services (CMS) report found that more than 45% of practice locations found in online directories are wrong.

Alliance To Develop Needed Provider Data Strategies

The Alliance participants will wrestle with problems such as how to manage frequently changing data for practices that move or health care professionals who retire or experience other life events. Currently in many cases, providers must follow a burdensome and redundant process where they inform many healthcare organizations and health plans of such changes.

Another key focus of the Alliance is increasing provider engagement in this maintenance process. The team will also work on industry-wide data definitions, improved accountability measures, greater regulatory alignment and centralized data resources.

The Alliance roadmap as facilitated by CAQH has an aggressive schedule, with work continuing through the summer and an expected release for fall 2017. Stay tuned for an update when the group reveals their recommended strategies and action items.

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If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.

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