December 20, 2017 | 2:00 PM to 3:00 PM EST
Join CAQH for a panel discussion with Humana, PokitDok and WorkComp EDI, three of the organizations to complete Phase IV CORE Certification. The Phase IV CAQH CORE Operating Rules address electronic transactions for healthcare claims, prior authorization, enrollment or disenrollment in a health plan and premium payments. Conformance with the rules means that providers will know in real-time if healthcare claims and requests for prior authorization were received by the health plan and are under review, among many other benefits.
The Panel will discuss why they decided to pursue Phase IV CORE Certification, any challenges they encountered during the CORE Certification process, as well as the value and efficiencies they anticipate from implementation.
January 11, 2018 | 2:00 PM to 3:00 PM EST
Emerging value-based payment (VBP) models are critically important in meeting future needs for improving the quality and cost of healthcare. This webinar will feature Laura Sessums, M.D., from the Center for Medicare and Medicaid Innovation (CMMI) Seamless Care Models Group. Dr. Sessums will discuss how practices are working in Comprehensive Primary Care Plus, a national primary care medical home model. This webinar is the second in an ongoing educational series from CAQH CORE to address operational challenges inherent in the transition to VBP.
Use and Adoption of Attachments in Healthcare Administration, Part IV: Clinical Document Architecture Basics – Clinical Content
January 18, 2018 | 2:00 PM to 3:30 PM EST
Providers want to improve their ability to electronically submit additional documentation to support the adjudication of claims, prior authorization, audits and other needs. One way to save time and improve efficiencies is to transmit these attachments electronically. Webinar attendees will learn how efficient use of an electronic attachment can reduce administrative burden, understand the clinical document metadata for attachments and get an overview of future attachment standard frameworks. This is the fourth webinar in a series and will be a technical training for an intermediate or advanced audience.
CAQH will be exhibiting or speaking at the following events:
Strategic Solutions Network 11th Healthcare Payments Innovations
January 22-23, 2018, Phoenix, AZ
Robert Bowman, a CAQH CORE Director, will discuss how to improve revenue cycle performance with operating rules for healthcare transactions on January 22 at 5:20 PM. The conference will explore topics including next generation payment models and financial performance and transparency.
2018 American Academy of Dental Group Practice Expo
January 31 – February 3, 2018, Las Vegas, NV
Join CAQH at the American Dental Association booth (ADA) to learn how the ADA and CAQH are simplifying the credentialing process for dentists. CAQH staff will be present to answer questions and demo the new ADA credentialing service, powered by CAQH ProView.
National Credentialing Forum 2018
February 1-2, 2018, San Diego, CA
Sorin Davis, Managing Director, Industry Relations, will provide a CAQH update at the National Credentialing Forum on February 1 at 3:15 PM. Each year the forum brings together organizations and individuals interested in credentials verification for health care professionals to share information.
Kyra Newman, CORE Associate, Education and Outreach
Kyra will assist with the development of new resources to educate stakeholders about CAQH CORE initiatives. Kyra has a background in social work and has developed and led numerous training programs for mental health nonprofits.
Michael Rabhan, Senior Manager, Business Development
Michael Rabhan is promoting CAQH solutions to the southeast region. He has twenty years of sales experience with more than a decade in the healthcare and dental markets, most recently with P&R Dental Strategies.
Kelly Rose, Sales Operations Manager
Kelly is responsible for all sales operations functions at CAQH. Prior to joining CAQH, she was a salesforce.com project manager and consultant at TechnoMile. Kelly has more than seven years of operations and Customer Relationship Management (CRM) experience.
Mangai Thiagarajan, Senior Technology Manager
Mangai works on CAQH ProView and DirectAssure. She began her career as a programmer and since then has held positions in solutions architecture, project implementation, product development and operations management.
CAQH in the News
CAQH CORE Opens Certification for Electronic Prior Authorization, RevCycleIntelligence
WEDI announces 24 annual award winners, Becker’s Hospital Review
HHS Pilot Encourages Streamlined Health Plan HIPAA Compliance, Health Payer Intelligence
ADA Partners with CAQH to Streamline Credentialing, Dentistry Today
Zocdoc appointment booking app now verifies insurance with AI, Healthcare Finance News
ADA Collaboration seeks to help streamline credentialing process for dentists, Emmot on Technology.com
Health care billers that don’t shed paper will pay a price, Payments Source
TIBCO BusinessConnect Supports Real-time Healthcare Transactions, TIBCO Software, Inc.