SSI Group and Availity, two leading revenue cycle management companies, are the latest organizations to achieve new CAQH CORE Certifications. Both are now CAQH CORE-certified for Prior Authorization & Referrals (infrastructure). Availity also achieved certification for Health Care Claims. Previously, both SSI and Availity were CAQH CORE-certified for Eligibility & Benefits, Claim Status and Payment & Remittance.
Managing coordination of benefits (COB) is challenging for many health plans, but Medicaid plans face among the greatest obstacles. For example, Medicaid beneficiaries often have multiple breaks in coverage in a single year, resulting in data becoming outdated quickly. These plans also have limited resources for identifying third-party liability, although they are required by law to do so.
And now, as team members involved in COB work remotely, these hurdles can become even greater.
Now that states have started the process of reopening and our healthcare system is beginning to return to normal operations, this is an ideal time for providers to make sure their professional and practice information in CAQH ProView is up to date.
CAQH CORE is hosting a series of interactive webinars to give healthcare leaders an opportunity to engage and collaborate during this time of social distancing.