- Operating Rules
- CORE Certification
- Value-Based Payments
- Industry Topics and Comment Letters
- Education and Implementation Resource Center
- HHS HIPAA Compliance
- Join CORE
- Provider Data Management
- CAQH ProView
- Provider Directory - DirectAssure
- COB Smart
- Provider Data Management
- CAQH Index
- Provider Data Collaboration
NATIONAL EFFORT TO SIMPLIFY THE CREDENTIALING PROCESS FOR PHYSICIANS LAUNCHES IN MAINE
WASHINGTON, DC - 6/16/03–
To ease credentialing for Maine 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 health care organizations. Participating health plans in Maine include Aetna Health, Inc., Anthem Blue Cross and Blue Shield, CIGNA HealthCare, The First Health Network/CCN Network and Great-West/One Health Plan.
The new CAQH Universal Credentialing DataSource service enables physicians to satisfy the credentialing needs of all participating health care organizations by submitting their information just one time, either on the Web or by fax. Information can be updated anytime, and the free, secure service makes it possible for physicians and their office staffs to spend just a few minutes each quarter to confirm that their credentialing data 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 During this timeframe, information often becomes outdated.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 average physician contracts with as many as 10 to 20 health plans, and completing a separate credentialing form for each one can be a drain on their time and resources, said Karen Bell, medical director, Anthem Blue Cross and Blue Shield. With the launch of Universal Credentialing DataSource, CAQH members are pleased to introduce the Maine medical community to a new, more user-friendly approach to submitting credentialing information.
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 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 members of CAQH worked closely with physicians to develop Universal Credentialing DataSource, and we're confident that the system will have a positive impact on their work lives,? said (name), (title), at Aetna. To make Universal Credentialing DataSource a truly universal tool for physicians in Maine and across the country, we've welcomed all health plans to participate in this effort. As more plans participate, the service will become an even more valuable timesaving tool for physicians and their staffs.
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, Florida, Georgia, Illinois, Iowa, Indiana, Kansas, Kentucky, Maine, Maryland, Missouri, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Tennessee, Texas, Virginia, Washington, D.C., and Wisconsin. CAQH is launching Universal Credentialing DataSource nationwide in 2003.
To raise awareness of the availability of Universal Credentialing DataSource in Maine, 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 contact their health plan 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 health care 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, CareFirst BlueCross BlueShield, CIGNA, Empire Blue Cross and 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.
# # #