November 2018

Launch of CAQH ProView for Groups

November 2018

CAQH announced the launch of CAQH ProView for Groups, a solution that is simplifying the way data is shared between delegated provider groups and health plans. It is the first-of-its-kind solution, replacing a highly manual process with an intuitive, efficient module within CAQH ProView.

CAQH Offers Solutions Suite to Improve Credentialing Process

November 2018

In response to the growing need for more streamlined and accurate provider credentialing, CAQH established an end-to-end process that simplifies data collection, primary source verification and sanctions monitoring.

CAQH CORE Calls for Work Group Participation to Help Improve Prior Authorization Process

November 2018

CAQH CORE has continued to work and educate industry leaders on the importance of improving the prior authorization process. At the end of September, the Prior Authorization Subgroup completed the development of draft operating rules, which will now go through the Formal Voting Process.

CAQH Recognized as Best Place to Work Three Years in a Row

November 2018

CAQH received a Best Place to Work in Healthcare award from Modern Healthcare for the third year in a row. For more than a decade, Modern Healthcare has awarded the “Best Places to Work in Healthcare” to outstanding employers that empower and support their staff to make an impact within the healthcare system.

Other News


Upcoming Webinars


Go Paperless and Get Paid: Use of the EFT/ERA Transactions with X12 and OhioHealth

November 14, 2018 | 2:00 PM - 3:00 PM ET

Do you want to learn how to create a more efficient payment and remittance advice process at your organization? One sure way to save time and money is through efficient use of the Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) transactions and the Phase III CAQH CORE Operating Rules. On this webinar, hear from speakers who are successfully using these transactions and operating rules to streamline healthcare payments.



Recent Webinars - Recordings Available


Prior Authorization Industry Landscape

This webinar presents industry activities to respond to the challenges of the inefficient prior authorization (PA) process, specifically the Consensus Statement on Improving Prior Authorization and related initiatives, WEDI PA efforts and CAQH CORE operating rule development.

Watch the on-demand webinar recording here.


How CAQH ProView for Groups is Transforming the Way Amerigroup Tennessee Manages Delegated Data

CAQH ProView for Groups is a major enhancement to CAQH ProView that streamlines data sharing between health plans and delegated groups, resulting in better quality data with less manual effort. In this webinar, you will hear from Amerigroup Tennessee on their process for implementing the solution, the benefits they have already experienced and how delegated groups utilize the tool.

Watch the on-demand webinar recording here.


On The Road


2018 National Association of Medicaid Directors - Fall Conference

November 12 – 14 | Washington, DC

CAQH staff will be at booth #17, discussing opportunities for health plans and Medicaid agencies to reduce administrative burden.


2018 Texas Association of Health Plans Annual Managed Care Conference

November 12 – 14 | Houston, TX

Sorin Davis, Senior Vice President of Industry Relations, will participate on the panel entitled: Automating Complexity: How to Manage Provider Directories and Provider Contracting. Panelists will discuss how to leverage automated solutions for network optimization, provider contracting challenges and remediation strategies. The panel will take place Tuesday, November 13th from 3:00 PM - 3:50 PM.


In The News


CAQH Software Aids Data Sharing Between Providers and Insurers, Health Data Management

Coming Together to Streamline Value-Based Payment, American Journal of Managed Care

Walk the Streamline, Group Practice Journal

How Blockchain Could Make Waves in Healthcare, Medical Economics

Using Payer Enrollment to Jumpstart Revenue Cycle Optimization, RevCycle Intelligence

Myths Around Virtual Payment: 3 Things to Consider, Becker’s Hospital Review

Administrative Efficiency Summit Seeks Solutions to Help Dentists Prioritize Patients Over Paperwork, ADA News