CAQH Press Releases | Affordable Quality Health Care Press | News

Business partners help health plans meet ACA requirements and promote secure and efficient exchange of administrative data

WASHINGTON, DC - 6/9/16

Health plan trading partners are increasingly seeking CORE Certification as a way to help their clients improve administrative processes and meet Affordable Care Act (ACA) requirements, according to the CAQH Committee on Operating Rules for Information Exchange (CORE).  CAQH CORE has awarded nearly 300 Certifications to date, nearly half of which are to entities that facilitate efficient electronic transactions for health plans.   

New Industry Progress Report Finds Increasing Adoption of Fully Electronic Claims-Related Processes, But Opportunity for Significant Improvement Remains

WASHINGTON, DC - 3/30/16

The U.S. healthcare system is unnecessarily spending billions of dollars each year by continuing to use manual administrative processes for basic transactions, according to the 2015 CAQH Index® released today. Despite steady increases in the industry adoption of HIPAA electronic administrative transactions, the report emphasizes a remaining opportunity to save more than $8 billion each year.

Leader in Provider Data Enables 1.3 Million Providers to Use Self-Reported Information in CAQH ProView to Meet New Regulations

WASHINGTON, DC - 2/17/16

The non-profit alliance CAQH today announced a new, fully-electronic solution to improve the quality of provider data in health plan directories. Launching as regulatory requirements increase for accurate provider directory information, DirectAssure is designed to help relieve the associated burden on healthcare providers.

CORE Certification becomes the gold standard for electronic healthcare data exchange

WASHINGTON, DC - 11/4/15

The CAQH Committee on Operating Rules for Information Exchange (CORE®) today announced that it has awarded more than 200 CORE Certifications to health plans, hospitals and health systems, clearinghouses and vendors.  Widely regarded as a must-have seal of approval across the healthcare industry, CORE Certification signifies that these organizations follow a set of HIPAA-mandated standards and operating rules for exchanging electronic administrative data.

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

WASHINGTON, DC - 9/4/14

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.

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