May 2020
For years, inaccurate provider directory data has been a concern for the healthcare industry - causing frustration for health plans and providers, and potentially creating barriers to care. As CAQH highlighted in the white paper The Hidden Causes of Inaccurate Provider Directories, one of the causes of directory errors is the administrative burden practices face when responding to a high volume of health plan requests for information and updates. Now more than ever, providers and practices need to dedicate all available resources to patient care rather than administrative processes.… Read more »
May 2020
Provider data drives the most fundamental processes in the healthcare system. The industry uses provider data to connect patients with healthcare providers, license practitioners, exchange information and pay for services. Though the industry spends more than $2 billion annually to maintain provider data, inaccuracies and inefficiencies persist. A variety of factors contribute to poor quality provider data, such as the proliferation of proprietary platforms and technologies. To address this problem, more health plans are seeking to consolidate the management of various related functions in… Read more »
May 2020
Epic, an industry-leading software provider, has become the newest member of  the CAQH CORE Board. Founded in 1979, Epic now handles medical records for more than 250 million people worldwide through its catalogue of software platforms. Their technology is widely used in hospitals, retail clinics, independent practices and academic medical centers, among other settings. “As one of the most widely used electronic medical records platforms in the United States, Epic has an invaluable perspective on interoperability, automation and connectivity,” said April Todd. “We are thrilled to have their… Read more »
May 2020
CAQH employees have come together—virtually—to show their support for healthcare workers on the frontlines of COVID-19. Responding to Children’s National Hospital’s urgent need for iPads compatible with systems in their containment area, treatment rooms and other facilities, team members from across CAQH collected enough funds to donate thirty devices. The iPads have been put to immediate use by emergency department doctors. CAQH is proud of and inspired by its employees and the generosity they have shown during this difficult time.
April 2020
Our nation’s healthcare system is being tested like never before. In the fight against COVID 19, healthcare workers are putting their lives on the line around the clock. Health plans are doing everything possible to expand access, remove barriers and support those delivering care.  At CAQH, we want to say thank you to all of those who are working so hard and sacrificing so much.  We also want them to know that we will continue to deliver the services and solutions that they have come to rely on. Our employees are working virtually—apart, yet in concert—to provide seamless support to… Read more »
April 2020
At CAQH, we continuously search for new ways to streamline administrative processes for providers, health plans and other participating organizations. To simplify how providers complete their initial profile, the CAQH ProView application will no longer require the Attestation Authorization and Releases (AARs) to be hand signed. Beginning immediately, we will also accept computer-generated signatures. Please note, this change does not apply in the following thirteen states which continue to require wet signatures: CO, GA, IL, MA, MN, MS, NV, NC, OK, OR, TX, WA and WV. This change, which… Read more »
April 2020
The following CAQH ProView® releases will be effective April 20, 2020: License Upload Requirements Follow Changes in FSMB Rules In response to COVID-19, the Federation of State Medical Boards (FSMB) relaxed rules regarding physician licensure during the State of Emergency, extending physician renewal dates as much as 90 days after the end of the emergency, varying by state. With this release, providers will no longer be required to upload a license copy to their CAQH profile. This enhancement will benefit providers that might not have new licenses at their next attestation due to the… Read more »
April 2020
X12 and CAQH CORE will host the Introduction to the 278 Transaction, Standard and Operating Rules webinar on April 30 at 2:00 pm ET. During this session, experts from both organizations will provide insights into how to utilize this transaction to electronically submit prior authorization and referral requests. They will also discuss how CAQH CORE Operating Rules for Prior Authorizations can further standardize components of this process across healthcare. This is the latest installment in an educational webinar series that the organizations launched in collaboration last year to close the… Read more »
March 2020
Recently, representatives from health plans across the country convened in Washington DC for the third COB Smart Symposium. The event represents a rare opportunity for thought leaders to meet in person to share best practices and collaborate on strategies to improve the coordination of benefits (COB) process. Traditionally, COB is managed through manual, reactionary processes that often result in unnecessary administrative burdens, and lost revenue. However, plans are increasingly adopting automated processes that allow them to manage payments before a claim is submitted. Sessions from the… Read more »
March 2020
Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, has joined other national health benefits companies in the effort to improve the accuracy of health care provider directories by participating in CAQH DirectAssure®. “Our nation’s fragmented approach to maintaining provider directories is undermining the quality of the data and imposing a costly burden on providers,” said CAQH President Robin Thomashauer. “The best way to overcome this challenge is for the industry to work together. The participation of Humana, one of the nation’s largest and most… Read more »