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NATIONAL EFFORT TO SIMPLIFY THE CREDENTIALING PROCESS FOR PHYSICIANS LAUNCHES IN ILLINOIS
WASHINGTON, DC - 2/27/03–
To ease credentialing for Illinois 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 free service to help physicians more easily and cost-effectively provide required credentialing information to health care organizations under the Illinois Health Care Professional Credentials Data Collection Act.
Participating health plans in Illinois include: Aetna, Blue Cross and Blue Shield of Missouri, CIGNA HealthCare of Illinois, The First Health Network/CCN Network, Great-West/One Health Plan, HealthLink, MultiPlan, Private Healthcare Systems, and UNICARE/WellPoint.
The CAQH Universal Credentialing DataSource enables physicians to satisfy the credentialing needs of all participating health care organizations by submitting required information one time, either online or by fax, in accordance with the Illinois three-year uniform cycle. On the Web, Universal Credentialing DataSource presents an electronic version of the application specified in the Illinois Health Care Professional Credentials Data Collection Act.
Universal Credentialing DataSource eliminates the redundancy associated with filling out multiple paper applications, enabling fast, secure and easy fulfillment of required credentialing information. The electronic application makes short work of entering credentialing information with such features as pre-populated fields, drop-down menu selections, logic-based date chronology, and automatic messaging to communicate application status. The system also prompts providers via e-mail or fax to update their credentialing applications every six months to comply with the Illinois regulations.
"When doctors are given more time to devote to patient care, everyone wins," said Ed Wristen, president and CEO of First Health. "I speak for all CAQH members in recognizing the launch of Universal Credentialing DataSource as a milestone for the Illinois medical community."
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 completed 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 data center, and is only made available to health care organizations that have been authorized by each physician. The CAQH system helps ensure physician information is accurate and up-to-date for credentialing and payment processing, and for use in health plans' electronic and paper directories. Health care organizations are automatically notified when a physician's information changes.
"Universal Credentialing DataSource is a great example of how industry representatives are working together to help simplify administrative processes such as credentialing for physicians and their staffs," said Christine Stoll, M.D., vice president, network development in Chicago, Ill., for UNICARE, a national operating subsidiary of WellPoint Health Networks Inc. "This credentialing system is a winning proposition for all partners in the health care industry, and one that we're certain the Illinois health care community can 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, Texas and Florida. CAQH plans to launch Universal Credentialing DataSource nationwide in 2003.
To raise awareness of the availability of Universal Credentialing DataSource in Illinois, CAQH has mailed a registration kit to physicians in the state who require re-credentialing (as determined by their social security number), inviting them to participate in the service. For providers who require initial credentialing, registration kits will be mailed on an as-needed basis. 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.
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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