CAQH Solution Brings Transparency to Verifying Healthcare Provider Credentials

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WASHINGTON, DC - 12/13/2018

CAQH today announced upcoming advanced new functionality for VeriFideTM, the automated solution that authenticates the accuracy and completeness of credentialing information submitted by healthcare providers to health plans. These latest updates to the primary source verification (PSV) solution offer plans real-time visibility into the credentialing status of each provider throughout the verification process.

“VeriFide improves the speed and accuracy of credentialing verification,” said Tarun Theogaraj, Senior Product Manager for CAQH. “The enhanced tracking functionality is a game changer.  Now health plans are able to know, with specificity, when a provider’s credentials will be verified and when he or she can be added to the network.” 

VeriFide deploys advanced automated technologies to compare provider information against primary data sources for accuracy. This reduces time, effort and the likelihood of human error. CAQH guarantees that VeriFide will return 98 percent of initial files within 14 days, with 98.5 percent accuracy and completeness.

For providers and practice managers, VeriFide helps reduce the time between when they submit their credentials to when they may participate in a plan network and receive payment for services. For plans, the PSV process is faster, more accurate and less costly than other approaches, and it eliminates the “chase work” involved in tracking down primary data sources.

The new VeriFide functionality includes a self-service portal that provides users with visibility into the PSV process, addressing the long-standing problem for many credentials verification organization (CVO) customers of not knowing how their orders are progressing. A management dashboard shows summary charts, as well as details, such as the exact status of an individual provider undergoing PSV.

CAQH is an NCQA-certified CVO. VeriFide is one solution within the CAQH provider data management suite that also includes:

CAQH ProView® which 1.4 million providers use to share professional and demographic information through a single secure, online process with multiple health plans.

DirectAssure® which increases the accuracy of health plan directories by giving providers an efficient way to review and update their self-reported professional data.

SanctionsTrack® which scans more than 500 state and federal sources to deliver timely information on disciplinary actions taken against providers.

“CAQH and our members are working every day to identify and overcome obstacles to reliable and secure provider data,” said Robin Thomashauer, CAQH President. “This is a problem that impacts all stakeholders plans, providers and consumers and we are making great strides to solve it.”