January 2019

New Report Highlights Industry Progress Toward Full Automation

January 2019

The latest CAQH Index report shows that the healthcare industry continues to make progress toward automating business processes as the number of transactions increases. The sixth annual CAQH Index, released earlier this month, is the industry standard for tracking health plan and provider adoption of fully electronic administrative transactions. The report provides insights into how the business of healthcare is changing, calls for greater industry collaboration and identifies opportunities for cost savings. Major takeaways include:

Collaboration is Improving Healthcare Provider Directories

January 2019

Accurate provider directory information is an imperative for the U.S healthcare system. It impacts the ability to find a healthcare provider and plays an important role in access to care. Yet, maintaining up-to-date provider directories is too often a burdensome and highly manual process for both health plans and providers.

Verifying Provider Credentials is Easier than Ever

January 2019

The credentialing process can be cumbersome for both healthcare providers and health plans. After provider data collection, health plans defer credentialing decisions until they complete primary source verification (PSV). The PSV process is often time-consuming and results in redundant outreach as multiple plans request the same information from a provider.

Humana Joins CAQH

January 2019

CAQH recently announced that Humana has joined the organization as a member health plan and is now represented on the CAQH board of directors. Humana has participated in CAQH initiatives for many years and is strengthening its commitment to streamline healthcare business processes by becoming a member.