September 2018

Last month, the CAQH CORE Board submitted an open letter in support of the Consensus Statement on Improving the Prior Authorization Process, which shares many CAQH CORE goals, such as improved transparency and communications, continuity of patient care and automation and efficiency.

Committed to collaborating with industry… Read more »

September 2018

The ongoing need to reduce administrative expenses in healthcare—while concurrently increasing information accuracy—is at the heart of CAQH activities that benefit the healthcare providers, health plans and agencies that serve Medicaid patients.CAQH CORE®

Medicaid agencies and health plans have a significant opportunity to save more than $4.8 billion annually by adopting CAQH… Read more »

September 2018

HealthCare Administrative Solutions (HCAS), a non-profit organization of Massachusetts-based health plans, has chosen DirectAssure® after an extensive search for a solution to improve healthcare provider directories in the state.

With DirectAssure, providers enter their directory information changes once and share them with multiple plans. The solution works in concert with CAQH ProView®, an online database used by more than… Read more »

July 2018

CAQH has achieved Certified status for information security by the Health Information Trust (HITRUST) Alliance. The HITRUST certification validates that CAQH meets key healthcare regulations and requirements for protecting and securing sensitive private healthcare information. The certification applies to CAQH infrastructure, security and privacy programs and the entire portfolio of CAQH Solutions (CAQH ProView, DirectAssure, VeriFide, EnrollHub, SanctionsTrack and COB Smart).

HITRUST CSF (common security framework) has become the most widely adopted security framework in the U.S.… Read more »

July 2018

The healthcare industry has made moderate progress in the adoption of electronic business transactions, but significant savings potential remains for healthcare providers and health plans, according to the 2017 CAQH Index released on June 14th. The fifth annual CAQH Index measures adoption, costs and provider labor time associated with the most common administrative transactions conducted between health plans and providers. These include verifying a patient’s insurance coverage,… Read more »

July 2018

CAQH is pleased to announce that our work to simplify the business of healthcare is having an increasing impact. As we hire more staff to meet new demands for our growing portfolio of solutions, we have outgrown our current office space.

CAQH is moving its physical address in Washington, DC, in August. CAQH will be relocating to:

2020 K Street
Suite 900
Washington, DC 20006

CAQH fax and phone numbers, the CAQH website and email addresses will not change when CAQH moves. CAQH does not anticipate any disruption in service during this change… Read more »

May 2018

The Provider Data Action Alliance (PDAA), a diverse group of 20 healthcare leaders convened by CAQH, has released a roadmap outlining recommendations to address provider data issues impacting healthcare providers, patients and health plans. The industry spends $2 billion annually to maintain provider data, yet errors and inefficiencies remain, disrupting many crucial processes in the healthcare system.

“… Read more »

May 2018

Modern Healthcare Best Places Award 2018

Modern Healthcare recognized CAQH on its list of the Best Places to Work in Healthcare for 2018. This is the third year in a row… Read more »

March 2018

The U.S. healthcare economy is undergoing a transformation in how care is measured, billed and paid. Organizations around the country are shifting away from fee-for-service models that reimburse providers for the volume of care, and experimenting with value-based payment models, which align quality of care and cost controls with provider compensation. As value-based payment innovation continues, there are many threats to its progress, such as operational challenges.

Yesterday, CAQH CORE® released a… Read more »

March 2018

In its second year of adoption, DirectAssure has established itself as a leading solution for health plans to address the ongoing challenge of maintaining accurate provider directories. Making changes to directory information is seamless for healthcare providers, who use CAQH ProView to easily review and update their professional information. DirectAssure participating organizations, including most national plans, are already using the solution to manage directory data for more than 800,000 providers. On average, about 600,000 of those providers… Read more »