CAQH Press Releases | Affordable Quality Health Care Press | News

CAQH CORE Announces Phase IV Package for Claims, Prior Authorization, Employee Premium Payment, Enrollment and Disenrollment

WASHINGTON, DC - 9/23/15

The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today announced the approval of the Phase IV CAQH CORE Operating Rules package for four healthcare business transactions: healthcare claims; prior authorization; employee premium payment; and enrollment and disenrollment in a health plan.

2014 CAQH Index Shows Progress, Gaps in Switch from Manual to Electronic

WASHINGTON, DC - 3/17/15

U.S. healthcare could save $8 billion annually by transitioning six routine business transactions from manual to electronic, according to the newly published 2014 CAQH Index™. The CAQH Index tracks progress from manual (e.g., via phone, fax or mail) to industry standardized (HIPAA) electronic administrative transactions between health plans and healthcare providers. This annual report, the second from CAQH, details adoption rates and potential savings.

Milestone Reflects the Added Value Certification Brings to Operating Rules Implementation

WASHINGTON, DC - 10/15/14

The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today announced that healthcare organizations have voluntarily earned more than 150 CORE Certifications and many additional organizations have pledged to become CORE-certified. These commitments are a promising development in the drive to achieve interoperability through end-to-end adoption of healthcare operating rules.

CAQH Solution Provides Instant Access to Coordination of Benefits Information


CAQH® today announced that COB SmartTM has launched in all 50 states and the District of Columbia, enabling health plans and providers to identify overlapping insurance coverage nationwide. A CAQH SolutionTM, COB Smart determines when an individual is covered by more than one insurer and also indicates which insurer should pay first. The solution streamlines coordination of benefits (COB) activities so that healthcare claims can be processed correctly the first time.

Providers Opt for Single Source to Enroll in EFT & ERA with Multiple Payers

WASHINGTON, DC - 6/17/14

CAQH® today announced participation by several additional healthcare payers in its electronic funds transfer (EFT) and electronic remittance advice (ERA) enrollment tool. The tool lifts a longstanding administrative barrier to broad use of electronic payments in healthcare by establishing a single online enrollment hub that eliminates the need for providers to enroll in EFT and ERA separately with each payer.

WASHINGTON, DC - 3/25/14

DecisionHealth, a leading source for health care news, analysis and instructional guidance, announced today that it will be including CAQH, a nonprofit alliance of health plans and trade associations aimed at simplifying health care administration, to enhance onsite training at the 14th Annual National Provider Enrollment Workshop 2014: Solve your Medicare and Commercial Payer Enrollment Challenges.

COB SmartTM delivers timely and reliable coordination of benefits (COB) information

WASHINGTON, DC - 2/19/14

CAQH® and a number of major health plans today announced the launch of COB Smart™, a national coordination of benefits (COB) registry that enables providers and health plans to identify individuals with multiple forms of coverage before care is delivered. As a result, COB claims can be processed correctly the first time. The registry is already identifying COB for more than 100 million patients.

First Regional Health Information Organization and First-Ever Phase III CORE Certifications Awarded as Certification Queue Builds

WASHINGTON, DC - 10/9/13

The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today announced that Horizon Healthcare Services, Inc., New Jersey’s oldest and largest health insurer, has earned voluntary CORE Certification for its Phase I and Phase II CAQH CORE Operating Rules implementation. Nearly 70 organizations and products have voluntarily achieved one or more phases of CORE Certification.

Award Recognizes Universal Provider Datasource (UPD) for Collaboration and Positive Impact

WASHINGTON, DC - 4/24/13

 CAQH® today announced that it has been named by IDG’s Computerworld Honors Program as a 2013 Laureate. The annual award program honors visionary applications of information technology promoting positive social, economic and educational change.

CAQH earned the honor for facilitating industry-wide collaboration that uses technology to eliminate redundant administrative paperwork, saving providers an estimated 4.9 million hours and more than $147 million annually with its Universal Provider Datasource®(UPD®) initiative.

Voluntary Certifications Ensure Operating Rules Compliance and Enhance Value across Providers, Vendors, and Health Plans

WASHINGTON, DC - 4/18/13

CAQH® announced today that ten additional organizations, including leading health plans representing approximately 30 million covered lives, and prominent clearinghouses and vendors, have earned voluntary CAQH CORE Phase I or Phase II Operating Rules certification after completing a rigorous testing process. This brings to more than 60 the number of healthcare organizations and products that have achieved CORE certification.