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 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.

CAQH CORE recently announced that the Phase IV CAQH CORE Operating Rules package has been approved and the… Read more »

“Collaborating to Take Costs Out of the Business of Healthcare”

August 2015

Collaborative projects are advancing operational efficiencies, improving health plan and provider relations and reducing millions in costs for the healthcare system at large, according to examples recently provided by senior executives from three national health plans at AHIP Institute 2015.

The presentation by CAQH explored the advantages of using industry-wide collaboration to improve routine business processes. In the session, titled “Collaborating to Take Costs Out of the Business of Healthcare,” panelists explained how this approach helps ease the burden on individual health… Read more »

August 2015

At the inaugural hearing of the Affordable Care Act (ACA)-mandated Review Committee in June, CAQH CORE presented compelling testimony that operating rules have resulted in significant contributions to the business needs of the healthcare industry. CAQH CORE also emphasized that many opportunities still exist to use operating rules to achieve interoperable data exchange.

The Review Committee was created via the Affordable Care Act to periodically review existing administrative transactions for which standards, code sets, identifiers, or operating rules have already been adopted by… Read more »

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 infrastructure 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.

The… Read more »