- CAQH ProView
- COB Smart
- Provider Directory - DirectAssure
- Primary Source Verification
- Operating Rules
- CORE Certification
- Industry Topics and Comment Letters
- Education and Implementation Resource Center
- HHS HIPAA Compliance
- Join CORE
NATIONAL EFFORT TO SIMPLIFY THE CREDENTIALING PROCESS FOR PHYSICIANS LAUNCHES IN WYOMING
WASHINGTON, DC - 1/13/04–
To ease credentialing for Wyoming physicians, the Council for Affordable Quality Healthcare (CAQH) today announced the launch of its Universal Credentialing DataSource system in the state. CAQH, a not-for-profit alliance of the nation?s leading health plans and networks, developed this system to help physicians more easily and cost-effectively provide required credentialing information to healthcare organizations. Participating health plans and PPO networks in Wyoming include The First Health Network, the CCN Network and Great-West/One Health Plan.
As CAQH continues to launch Universal Credentialing DataSource nationwide, tens of thousands of physicians have adopted the unique system and are realizing its benefits. Universal Credentialing DataSource enables physicians to satisfy the credentialing needs of all participating healthcare organizations by entering their information one time to the uniform system. Application data can be submitted anytime through the convenience of the Web or by fax. The free, secure service also makes it possible for physicians to spend just a few minutes to periodically update their data online or by phone and to confirm that their credentialing information is complete and accurate.
Today, physicians face the redundant and time-consuming process of credentialing or recredentialing with individual health plans once every three years. During this timeframe, information often becomes outdated. The CAQH system provides a time-saving solution that helps ensure information is up-to-date for credentialing and payment processing, and for use in health plans? electronic and paper directories.
"We are pleased to make Universal Credentialing DataSource available to physicians in Wyoming," said Scott Smith, M.D., chief medical officer, First Health. "The system alleviates the excessive paperwork and redundancies that have made conventional credentialing procedures so burdensome. We strongly encourage physicians to check out Universal Credentialing DataSource and see for themselves what a positive difference it can make in their practice."
Any healthcare organization with credentialing requirements is encouraged to participate in Universal Credentialing DataSource. All participating healthcare organizations pay an annual per physician/provider fee for unlimited access to completed records, in addition to a small annual administrative fee to offset system maintenance and customer service requirements. Physicians authorize access to participating healthcare organizations and each healthcare organization reviews and verifies credentialing data, and decides independently whether or not a physician meets its standards for participation.
Data collected through Universal Credentialing DataSource is maintained by CAQH in a secure, state-of-the-art data center, and is only made available to healthcare organizations that have been authorized by each physician. Healthcare organizations are automatically notified when a physician?s information changes.
"Physicians should feel confident the information they submit to Universal Credentialing DataSource will be shared only with their permission," said William McCallum, president and CEO of Great-West/One Health Plan. "Having a single source for credentialing data is beneficial for physicians and health plans. As more health plans and networks participate in Wyoming, the system will become an even more valuable tool."
To create Universal Credentialing DataSource, CAQH worked with providers, health plans and networks, professional associations, insurance regulators and accreditation associations. The service first launched in Virginia and Colorado in March 2002, and it is now also available to physicians in Alabama, Alaska, Arizona, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Rhode Island, South Dakota, Tennessee, Texas, Vermont, Washington, D.C., West Virginia, Wisconsin and Wyoming. CAQH will complete the nationwide launch of Universal Credentialing DataSource in 2004.
To raise awareness of the availability of Universal Credentialing DataSource in Wyoming, CAQH has mailed a registration kit to physicians in the state, inviting them to participate in the service. The kit includes a temporary ID that physicians can use to register in the system. Physicians who are affiliated with a participating health plan or network, but who have not received the registration kit, can call the Help Desk at 888-599-1771 or contact a participating health plan or network directly.
The Council for Affordable Quality Healthcare (CAQH) is a not-for-profit alliance of health plans and networks that promotes collaborative initiatives to help make healthcare more affordable, share knowledge to improve the quality of care, and make administration easier for physicians and their patients. Created in 1999, CAQH member organizations today provide and administer healthcare coverage for more than 100 million Americans.
CAQH members include: Aetna, American Association of Health Plans, Anthem Blue Cross and Blue Shield, AultCare, Blue Cross and Blue Shield Association, Blue Cross and Blue Shield of Michigan, Blue Cross and Blue Shield of North Carolina, BlueCross BlueShield of Tennessee, CareFirst BlueCross BlueShield, CIGNA, Empire Blue Cross Blue Shield, First Health, Great-West, Group Health Cooperative, Health Insurance Association of America, Health Net, Highmark Blue Cross Blue Shield, Horizon Blue Cross Blue Shield of New Jersey, Independence Blue Cross, MultiPlan, Mutual of Omaha, Oxford Health Plans, The Regence Group, and WellPoint.
# # #