- Operating Rules
- CORE Certification
- Value-Based Payments
- Industry Topics and Comment Letters
- Education and Implementation Resource Center
- Join CORE
- 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 TENNESSEE
WASHINGTON, DC - 1/1/02–
To simplify the way Maryland 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.
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.
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.
Officials from several Maryland health plans have been involved in developing the CAQH credentialing service, ensuring that it is fully compliant with the State of Maryland’s Universal Application Form regulations. CAQH also obtained the input of physicians, their professional associations, and national accrediting organizations.
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. In addition to CAQH members, non-member health plans, hospitals and related organizations can use the service to satisfy their credentialing needs.
There is no cost to physicians to use the Universal Credentialing DataSource service. Development and ongoing maintenance costs are covered by participating healthcare organizations.
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.
# # #