Responding to consumer concerns about the quality of healthcare provider directories, a number of federal and state directory requirements have recently gone into effect. Health plans must now regularly update and confirm the accuracy of their provider information, or face potential penalties. CAQH is helping health plans address these requirements with the launch of DirectAssure, which works in concert with CAQH ProView to improve provider directory data. This latest CAQH Solution eliminates the need for each health plan to reach out to the individual healthcare providers in their network to… 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 »
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 »