Newsletter Home Listing

May 2016

How does your organization compare to the rest of the healthcare industry in adopting electronic business transactions? The 2015 CAQH Index offers benchmark data, enabling organizations to see where they are excelling and where opportunities for improvement exist.  Specifically, the Index measures adoption rates, cost, and savings associated with the shift from manual to electronic HIPAA transactions between health plans and healthcare providers.

May 2016

As with other segments of healthcare, dental plans and dentists need to operate more efficiently to succeed amidst rising cost pressures and demand for high quality, affordable care. CAQH initiatives are helping the dental industry address business challenges through collaborative efforts that simplify administrative processes and reduce costs. Dental plans and dentists can participate in several CAQH initiatives to streamline their business processes.

May 2016

In a recent letter to the National Committee on Vital and Health Statistics (NCVHS), the multi-stakeholder CAQH CORE Board urged the recommendation of the Phase IV CAQH CORE Operating Rules to the Secretary of the Department of Health and Human Services (HHS).

March 2016

Responding to consumer concerns about the quality of healthcare provider directories, a number of federal and state directory requirements have recently gone into effect. Health plans must now regularly update and confirm the accuracy of their provider information, or face potential penalties. CAQH is helping health plans address these requirements with the launch of DirectAssure, which works in concert with CAQH ProView to improve provider directory data.

March 2016

Reliable provider data is necessary not only for care delivery, but also for efficient financial processes in healthcare. The need for accurate and timely provider data is continuing to grow. The healthcare industry is discovering new ways to share responsibility for quality provider data as government programs expand, new payment models evolve, cost pressures heighten and demands for transparency increase.

November 2015

CAQH CORE recently announced that it has awarded more than 200 CORE Certifications. Created and maintained with broad multi-stakeholder input, the CORE Certification program works with independent testing entities to evaluate whether organizations applying for certification use information systems that conform to the standards and operating rules. 

November 2015

Several of the nation’s leading dental plans are enabling dentists to sign up for electronic payments with multiple payers at one time. The plans are participating in EnrollHub® to simplify the process for electronic funds transfer (EFT) and electronic remittance advice (ERA) enrollment, removing a longstanding barrier to broad use of electronic payments among dentists and other healthcare providers.

On-Demand Webinar

October 2015

CAQH recently hosted a webinar with Kaiser Permanente and Blue Cross and Blue Shield of North Carolina (BCBSNC) to discuss how health plans can improve coordination of benefits (COB) through greater industry collaboration. Both health plans implemented a collaborative, secure solution to automate COB.

October 2015

Health plans, healthcare providers, and the clearinghouses and vendors that support them, now have national operating rules to improve how they can work together as trading partners. The voluntary operating rules will help streamline the electronic data exchange of four more healthcare business transactions: healthcare claims; prior authorization; employee premium payment; and enrollment and disenrollment in a health plan.

August 2015

CAQH has launched a redesigned website developed to communicate more effectively and improve the visitor experience. In addition to featuring refreshed branding that represents the mission and vision of the organization, www.CAQH.org now has a new structure that makes information easier to find.

As the scope of CAQH activities expands beyond simplifying administrative processes to focus more broadly on “streamlining the business of healthcare”, the redesigned website more comprehensively profiles the work of the organization.

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