National Single Credentialing Application Brings Added Convenience to Physicians
Acting on its pledge to ease physician paperwork, The Coalition for Affordable Quality Healthcare (CAQH), a non-profit coalition of healthcare organizations founded by 26 of the nation?s largest health plans and insurers covering more than 110 million Americans, announced today its plan to launch a sophisticated credentialing application system. "This new system will dramatically simplify the credentialing process and reduce paperwork for healthcare providers, health plans and hospitals," said H. Edward Hanway, chairman and CEO of CIGNA and chairman of CAQH.
The CAQH system will gather and store detailed data from more than 600,000 providers nationwide. These electronic records will be available anytime to authorized health plans and hospitals without requiring cumbersome paperwork and delays. This initiative, to be launched in the spring of 2002, is the first phase of CAQH?s broad multi-year plan to simplify not only the credentialing process, but also other administrative processes in the healthcare industry.
"One of the most time-consuming tasks facing providers and payers is the paperwork associated with credentialing," said Jay Gellert, president and chief executive officer, Health Net, and chair of the Administrative Simplification Committee for CAQH. "As part of our ongoing commitment to improving the healthcare experience, CAQH is reducing administrative hassles for providers across the country, giving them more time to focus on what?s important: their patients."
A typical provider contracts with 10 to 20 healthcare organizations, each of which requires the provider to complete an extensive credentialing application. Using the CAQH system, each provider will submit a single application to one central database to meet the needs of all of the health plans and hospitals participating in the CAQH effort. Providers may easily update their information online or via fax anytime, and will confirm once each quarter that the data on file is complete and accurate. During the course of the rollout, CAQH will invite health plans, hospitals and related organizations nationwide to utilize this data to maximize the benefits of the system for the entire healthcare industry. Organizations are not required to join CAQH to subscribe to the CAQH credentialing data system. Previous efforts to create a shared system for credentialing data have been limited to individual states, have appealed to only part of the healthcare industry, or simply lacked the technology available today. Marjorie O?Malley, senior vice president for CIGNA and chair of CAQH?s Credentialing and Provider Directory Work Group, said the CAQH system is designed to support the entire healthcare industry.
"CAQH is not a business; it is a not-for-profit coalition that enjoys the support of 26 of the nation?s largest health plans and key trade associations," said O?Malley. "CAQH continues to gather input from organizations representing healthcare providers, health plans, hospitals and even state legislatures to ensure that this system will meet the industry?s needs. Each organization will continue to make its own credentialing decisions, but we will reduce the cost and hassle of managing up-to-date provider data." CAQH development teams have agreed on a common set of required data and have incorporated state-adopted application forms where appropriate to provide a universal solution for providers and organizations nationwide.
After an extensive search, CAQH selected GeoAccess, a healthcare-focused technology and data management company, to build and administer the credentialing data system. GeoAccess was selected because of its well-established expertise in developing and managing highly scalable, secure systems for acquiring, storing, analyzing and communicating provider data for hundreds of clients throughout the healthcare industry. The confidentiality of the provider data and the privacy of system users are critical priorities.
Sorin Davis, executive vice president for Multiplan and chair of the CAQH Credentialing Marketing and Communication Subgroup, explains the coalition?s plans to launch the new system. "CAQH has selected pilot sites for testing early next year. Beginning next summer, the system will become available to providers nationwide. Within a year, we hope that every provider, health plan and hospital in the country will benefit from this industry-wide effort to drive down healthcare costs and improve patient care." More information about CAQH and a demonstration about its credentialing database can be found on the CAQH Web site at www.CAQH.org.
Companies and trade associations currently participating in CAQH are: Aetna; American Association of Health Plans; Anthem Blue Cross and Blue Shield; AultCare; Beech Street Corporation; Blue Cross Blue Shield Association; BlueCross and BlueShield of North Carolina; CareFirst BlueCross BlueShield; CIGNA; ConnectiCare, Inc.; Empire BlueCross BlueShield; FirstHealth; Great-West Life & Annuity Insurance Company; Group Health Cooperative of Puget Sound; Health Insurance Association of America; Health Net, Inc.; HealthPartners; Highmark Blue Cross and Blue Shield; Horizon Blue Cross Blue Shield of New Jersey; Independence Blue Cross; MultiPlan, Inc.; Mutual of Omaha; Oxford Health Plans; PacifiCare Health Systems Inc.; Private Healthcare Systems, Inc.; RightCHOICE Managed Care, Inc.; The Regence Group; Trigon Healthcare, Inc.; and WellPoint.
GeoAccess is a data-centric technology company focused exclusively on helping healthcare payors, providers and purchasers manage, analyze and communicate provider and network information. The company provides software and services to more than 1,000 clients including managed care organizations, government agencies, large employers, IPAs, IDNs, e-health companies and benefits consulting firms. GeoAccess supports the Internet's most popular physician-search engine, used by hundreds of clients generating millions of online directories each month for more than 100 million consumers. GeoAccess supports the industry's most popular network-analysis software, used to help health plans understand how well a provider network is positioned to serve its target patient populations. GeoAccess is the nation's largest independent credentialing solutions vendor, supplying primary source verification services, software and online tools. The company supports all of these solutions with the industry?s most robust and accurate national database of healthcare providers.
GeoAccess is privately held, with offices in Kansas City and Dallas. Visit GeoAccess at www.geoaccess.com. CONTACT: Norma Krayem/Sarah Leer (703) 299-4499