To simplify the way Connecticut physicians are credentialed, the Council for Affordable Quality Healthcare (CAQH) today announced the state launch of its Universal Credentialing DataSource service. CAQH, a not-for-profit alliance of America's leading health plans and networks, developed this service to help physicians more easily and cost-effectively provide required credentialing information to healthcare organizations.

Officials from several Connecticut health plans have been involved in developing the CAQH credentialing service and CAQH also obtained the input of physicians, their professional associations, and national accrediting organizations.

I am very encouraged that health plans in Connecticut are working together to improve how they deliver healthcare, said Dr. Joxel Garcia, commissioner of the Connecticut Department of Public Health. By allowing physicians to spend less time at their office desk and more time with their patients, this system benefits not only providers and plans, but patients as well.

We applaud the efforts of CAQH and participating insurers in Connecticut in spearheading a solution to a long-standing issue for physicians, said Susan Cogswell, Connecticut insurance commissioner. The credentialing initiative is further evidence of the goodwill that can be achieved when payers and providers reach out to one another.

The Challenge of Credentialing

For physicians, the process of regularly submitting licensing, educational and practice information to health plans, hospitals and other healthcare organizations is an essential, but often redundant and time-consuming administrative task. Credentialing is a consumer safeguard designed to verify a physician's qualifications. All physicians contracting with a health plan or hospital are required to periodically submit this information.

It is not uncommon for a physician to contract with 10 or more healthcare organizations, each of which requires a credentialing application, said Ellie Seiler, M.D., senior medical director at Anthem Blue Cross and Blue Shield. As a member of CAQH, Anthem is committed to easing this burden for physicians. We believe this credentialing initiative is an important first step in CAQH's commitment to help to simplify the business of healthcare.

The CAQH Universal Credentialing DataSource service allows a physician to submit one application that satisfies the credentialing needs of all participating health plans. The application can be submitted either via the Web or fax. Updates are collected on a quarterly basis by CAQH, ensuring that the data remains current. CAQH only makes this information available to health plans specifically authorized by each physician.

This collaborative process has given us the tools to simplify what has long been a tedious and repetitive administrative task, said Barry Averill, president of Health Net of the Northeast, Inc., which serves more than 500,000 members in Connecticut. We're looking at every way to reduce the hassle factor for physicians, hospitals, employers and our members. Through our joint efforts, CAQH is improving the credentialing data collection process not only for healthcare providers, but for health plans and hospitals too.

Universal Credentialing DataSource first launched in Virginia and Colorado in March 2002. It will be deployed in six additional states by the end of 2002, and launched nationwide in 2003. There is no cost to physicians to use the Universal Credentialing DataSource service. Development and ongoing maintenance costs are covered by participating healthcare organizations.

About CAQH

The Council for Affordable Quality Healthcare (CAQH) is a not-for-profit alliance of America's leading health plans and networks, committed to improving the quality of healthcare and reducing administrative burdens for physicians, patients and payers. Created in 1999, CAQH member organizations today provide and administer healthcare coverage for more than 100 million Americans.

CAQH members include: 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 HealthCare, Empire BlueCross Blue Shield, FirstHealth, Great-West, 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., The Regence Group, and WellPoint.

Rachel Rosten
(212) 445-8269

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