Accurate provider data is critical to improving quality, costs and healthcare delivery. Healthcare provider data forms the foundation of many important processes in the nation’s healthcare system. This information is necessary to conduct a number of essential functions, such as referring a patient to a specialist, paying insurance claims, determining provider sanctions and credentialing providers.
Provider Data Management
The suite of provider data management solutions by CAQH ensures that health plans have the high-quality provider information needed for a range of business uses including credentialing, directories, sanctions monitoring and EFT/ERA enrollment.
Developed in collaboration with health plans and providers, CAQH Solutions improve data accuracy, reduce administrative burden and costs, streamline businesses processes and mitigate compliance risks.
Press Release 04/04/17
CAQH announced the launch of a new electronic solution, VeriFide™, that streamlines primary source verification of the healthcare provider information required for health plan credentialing decisions. VeriFide will immediately improve the quality, speed and integrity of provider data sent to health plans as part of the credentialing process.
2016 CAQH Index Report 01/12/17
The fourth annual CAQH Index measures adoption, costs and, for the first time, provider labor time associated with the most common administrative transactions conducted between health plans and providers. These include verifying a patient’s insurance coverage, sending and receiving payment, inquiring about the status of a claim and obtaining prior authorization for care.
Press Release 09/28/16
Full industry collaboration is required to develop an effective approach to collecting, maintaining and disseminating accurate, high-quality data from healthcare providers, according to a new white paper from the non-profit alliance CAQH.