Reliable provider data is necessary not only for care delivery, but also for efficient financial processes in healthcare. The need for accurate and timely provider data is continuing to grow. The healthcare industry is discovering new ways to share responsibility for quality provider data as government programs expand, new payment models evolve, cost pressures heighten and demands for transparency increase. Executives Tim Kaja, SVP at UnitedHealth Group and Mariann Yeager, CEO of The Sequoia Project recently participated with CAQH in a panel discussion about provider data at the eHealth… Read more »
CAQH CORE recently announced that it has awarded more than 200 CORE Certifications. Created and maintained with broad multi-stakeholder input, the CORE Certification program works with independent testing entities to evaluate whether organizations applying for certification use information systems that conform to the standards and operating rules. Although CORE Certification is voluntary, health plans and hospital systems across the US are increasingly expecting their business partners to have earned the CORE Certification seal. The CAQH CORE Board Chair, George S. Conklin, CIO and SVP for… Read more »
CAQH recently hosted a webinar with Kaiser Permanente and Blue Cross and Blue Shield of North Carolina (BCBSNC) to discuss how health plans can improve coordination of benefits (COB) through greater industry collaboration. Both health plans implemented a collaborative, secure solution to automate COB. View the On-Demand Webinar or read an Executive Summary of the event to learn more about the challenges being addressed and the results being experienced by both organizations.
“Collaborating to Take Costs Out of the Business of Healthcare”
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 plans and… Read more »
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 mandate and… Read more »