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New Certification Progress Report Highlights Healthcare Industry Progress and Gaps in Move Towards Streamlined, Electronic Sharing of Administrative Data 


CAQH CORE, a multi-stakeholder collaboration of more than 130 public and private entities across the healthcare industry, announced today that it has awarded over 300 certifications to health plans, hospitals and health systems, clearinghouses and vendors. Aetna and Cigna, two of the nation’s largest insurers, recently became certified in the Phase III CAQH CORE Operating Rules, continuing the industry momentum toward more streamlined, electronic administrative data sharing. 

Providers Could Gain 1.1 Million Labor Hours Per Week with Full Adoption of Electronic Transactions

WASHINGTON, DC - 1/12/17

Widespread adoption of electronic business transactions in healthcare continues to grow but a significant opportunity for $9.4 billion in annual savings remains, according to new data released today in the 2016 CAQH Index®. Conducting resource-intensive manual transactions costs U.S. health plans and healthcare providers as much as $11 more per transaction and on average $6 more than when conducted electronically. Millions of these transactions are exchanged daily.

The fourth annual CAQH Index measures adoption, costs and, for the first time, provider labor time associated with the most common administrative transactions conducted between health plans and providers. These include verifying a patient’s insurance coverage, sending and receiving payment, inquiring about the status of a claim and obtaining prior authorization for care.