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NATIONAL EFFORT TO SIMPLIFY THE CREDENTIALING PROCESS FOR PHYSICIANS LAUNCHES IN DELAWARE
WASHINGTON, DC - 9/9/03–
To ease credentialing for Delaware physicians, the Council for Affordable Quality Healthcare (CAQH) today announced the launch of its Universal Credentialing DataSource system in the state. CAQH, a not-for-profit alliance of the nation?s leading health plans and networks, developed this system to help physicians more easily and cost-effectively provide required credentialing information to healthcare organizations. Participating health plans and PPO networks in Delaware include Aetna, CIGNA Healthcare, The First Health Network/CCN Network, and Great-West.
The new CAQH Universal Credentialing DataSource service enables physicians to satisfy the credentialing needs of all participating healthcare organizations by submitting their information one time to the uniform system. Data can be updated anytime through the convenience of the Web or by fax. The free, secure service makes it possible for physicians to spend just a few minutes each quarter to confirm that their credentialing information is complete and accurate.
Today, physicians face the redundant and time-consuming process of credentialing or recredentialing with individual health plans once every three years. During this timeframe, information often becomes outdated. The CAQH system provides a time-saving solution that helps ensure information is up-to-date for credentialing and payment processing, and for use in health plans? electronic and paper directories.
"Universal Credentialing DataSource represents a true evolution in the way physicians and health plans approach the credentialing and re-credentialing process," said Patricia Mueller, MD, Aetna?s regional medical director for the Mid-Atlantic. "We are certain that physicians in Delaware will be pleased with the many benefits the system has to offer, including a single, universal source for data collection, the potential for fewer errors, and the ability to ensure that health plans have access to their most current information. We encourage all physicians to learn more."
Any healthcare organization with credentialing requirements is encouraged to participate in Universal Credentialing DataSource. All participating healthcare organizations pay an annual per physician/provider fee for unlimited access to completed records, in addition to a small annual administrative fee to offset system maintenance and customer service requirements. Each healthcare organization reviews and verifies credentialing data, and decides independently whether or not a physician meets its standards for participation.
Data collected through Universal Credentialing DataSource is maintained by CAQH in a secure, state-of-the-art data center, and is only made available to healthcare organizations that have been authorized by each physician. Healthcare organizations are automatically notified when a physician?s information changes.
"The hallmark of this system is the collaboration that went into it," said Marjorie O?Malley, senior vice president, CIGNA HealthCare, and chair of the CAQH credentialing committee. "The input we?ve received from physicians nationwide, and the support of major health plans and networks, have been integral in developing a solution on the scale of Universal Credentialing DataSource. As more plans participate, the system will become an even more valuable tool for physicians in Delaware and throughout the country."
To create Universal Credentialing DataSource, CAQH worked with providers, health plans and networks, professional associations, insurance regulators and accreditation associations. The service first launched in Virginia and Colorado in March 2002, and it is now also available to physicians in Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Missouri, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Tennessee, Texas, Vermont, Washington, D.C., and Wisconsin. CAQH is launching Universal Credentialing DataSource nationwide throughout 2003.
To raise awareness of the availability of Universal Credentialing DataSource in Delaware, CAQH has mailed a registration kit to physicians in the state, inviting them to participate in the service. The kit includes a temporary ID that physicians can use to register in the system. Physicians who are affiliated with a participating health plan or network, but who have not received the registration kit, can call the Help Desk at 888-599-1771 or contact a participating health plan or network directly.
The Council for Affordable Quality Healthcare (CAQH) is a not-for-profit alliance of health plans and networks that promotes collaborative initiatives to help make healthcare more affordable, share knowledge to improve the quality of care, and make administration easier for physicians and their patients. 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, Blue Cross and Blue Shield Association, Blue Cross and Blue Shield of Michigan, Blue Cross and Blue Shield of North Carolina, BlueCross BlueShield of Tennessee, CareFirst BlueCross BlueShield, CIGNA, Empire Blue Cross Blue Shield, First Health, Great-West, Group Health Cooperative, Health Insurance Association of America, Health Net, Highmark Blue Cross Blue Shield, Horizon Blue Cross Blue Shield of New Jersey, Independence Blue Cross, MultiPlan, Mutual of Omaha, Oxford Health Plans, The Regence Group, and WellPoint.
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