- About CAQH CORE
- Operating Rules
- CORE Certification
- Value-based Payments
- Join CAQH CORE
- Resource Library
- CAQH ProView
- CAQH ProView for Groups
- CAQH ProView - Dental
- Provider Directory - DirectAssure
- Credentialing Solutions Suite
- COB Smart
NATIONAL EFFORT TO SIMPLIFY THE CREDENTIALING PROCESS FOR PHYSICIANS LAUNCHES IN FLORIDA
WASHINGTON, DC - 1/1/03–
To ease credentialing for Florida physicians, CAQH, the Council for Affordable Quality Healthcare, 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 health care organizations. Participating health plans in Florida include Aetna, CIGNA HealthCare of Florida, Inc., The First Health Network/CCN Network, Great-West/One Health Plan, MultiPlan and Private Health Care Systems (PHCS).
The new CAQH Universal Credentialing DataSource service enables physicians to satisfy the credentialing needs of all participating health care organizations by submitting their credentials one time to the uniform system. Information can be updated anytime through the convenience of the Web or by fax. The free, secure service makes it possible for physicians and their office staffs to spend just a few minutes each quarter to confirm that credentialing information is complete and accurate.
Today, physicians face the redundant and time-consuming process of credentialing or re-credentialing 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 During this timeframe, information often becomes outdated.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.
"The Universal Credentialing DataSource is a welcome enhancement to the very important process of credentialing,? said William E. Hauser, MD, Aetna?s Southeast Region Medical Director. ?Having a unified database such as this significantly reduces the administrative duplication that physicians have experienced in the past. It also increases the consistency and quality of information that is provided to multiple health care organizations that must credential and re-credential physicians on a regular basis to improve patient safety and access to quality medical care."
Any health care organization with credentialing requirements is encouraged to participate in Universal Credentialing DataSource. All participating health care organizations pay an annual per physician/provider fee for unlimited access to competed records, in addition to a small annual administrative fee to offset system maintenance and customer service requirements. Each health care 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 datacenter, and is only made available to health care organizations that have been authorized by each physician. Health care organizations are automatically notified when a physician?s information changes.
?The member health plans and networks of CAQH are proving that the industry can collaborate to simplify administrative processes like credentialing for physicians,? said Marjorie O?Malley, senior vice president, CIGNA HealthCare, who also serves as chairperson for the CAQH Universal Credentialing DataSource initiative. ?By also welcoming non-member health care organizations to participate in Universal Credentialing DataSource, our goal is to make it a truly universal solution for physicians nationwide. This credentialing system is a winning proposition for all partners in the health care industry, and one that we?re certain the Florida health care community will embrace.?
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 2002, and it is also now available to physicians in Maryland, Washington, D.C., Connecticut, New York, New Jersey, Georgia and Texas. CAQH plans to launch Universal Credentialing DataSource nationwide in 2003.
To raise awareness of the availability of Universal Credentialing DataSource in Florida, 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, but who have not received the registration kit, can call the Help Desk at 888-599-1771, or refer to the CAQH Web site at www.caqh.org for more information.
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.
# # #