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PHCS TO STREAMLINE PROVIDER SANCTIONS MONITORING THROUGH CAQH PROVIDER DATA-COLLECTION SERVICE
WASHINGTON, DC - 2/23/06–
CAQH, a nonprofit alliance of the nation’s leading health plans and networks working to simplify healthcare administration, announced today that Private Healthcare Systems (PHCS) will use its Universal Credentialing DataSource® (UCD) service to streamline provider sanctions monitoring.
PHCS (www.phcs.com) is the largest national proprietary PPO in the U.S. It will use UCD’s newest feature, the Ongoing Sanctions Monitoring Module, to track sanctions information about the 450,000 providers in its network.
The Ongoing Sanctions Monitoring Module simplifies the sanctions monitoring and review process by centralizing data collection from more than 400 sources, including all 50 state licensing boards, the Office of Inspector General, Office of Personnel Management and Medicare/Medicaid organizations. The service provides information about license revocations, felony convictions, quality of care issues, and other sanctions enforced against all types of providers (MD, DO, DPM, DC and others), as well as provider reinstatement announcements.
“By participating in our sanctions monitoring service, PHCS has taken a significant step toward reducing administrative burden while maintaining the integrity of their provider network,” said Robin J. Thomashauer, CAQH executive director. “We are very pleased that one of the nation’s leading PPOs has joined our administrative simplification initiative.”
“When we saw the efficiencies that could be achieved with the Ongoing Sanctions Monitoring Module, it was an easy decision,” said Paul Goldstein, M.D., PHCS senior medical director. “The CAQH service provides us immediate access to the wealth of information we need and frees up staff to focus on other critical administrative functions.”
Launched in 2002 by CAQH, UCD features a single, secure online application that facilitates the initial credentialing and re-credentialing processes, reduces provider administrative burdens and costs, and offers health plans and networks real-time access to reliable provider information for claims processing, quality assurance and member services, such as directories and referrals.
CAQH (www.caqh.org) is a catalyst for industry collaboration on initiatives that simplify and streamline healthcare administration. CAQH solutions help promote quality interactions between plans, providers and other stakeholders, reduce costs and frustrations associated with healthcare administration, facilitate administrative healthcare information exchange and encourage administrative and clinical data integration.
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