CAQH Press Releases | Affordable Quality Health Care Press | News

Guidelines established by industry will reduce inefficient information exchange between plans and providers, reduce costs, and help remove barriers to care

WASHINGTON, DC - 5/15/19

CAQH CORE today released Phase V Operating Rules approved by the CAQH CORE Board to strengthen the accuracy and consistency of the prior authorization process and move the industry toward full automation.

84 percent of “attachments” sharing medical information between providers and health plans are exchanged through mail or fax, resulting in administrative inefficiency and delays in patient care

WASHINGTON, DC - 5/2/19

CAQH CORE today released a white paper, “CAQH CORE Report on Attachments: A Bridge to a Fully Automated Future to Share Medical Documentation” on the challenges associated with the exchange of medical information and supplemental documentation used for healthcare administrative transactions. The report identifies five areas to improve processes and accelerate the adoption of electronic attachments.

WASHINGTON, DC - 3/20/19

CAQH CORE has awarded more than 350 certifications to healthcare organizations that conform to CAQH CORE Operating Rules. In becoming certified, these entities – which include health plans, Medicaid programs, providers, vendors and more – demonstrate their commitment to automation, interoperability and efficient business processes.

Technology delivers better data, more efficiently, with less provider abrasion

WASHINGTON, DC - 3/14/19

CAQH® has developed patent-pending artificial intelligence (AI) technology to identify incorrect healthcare provider data and improve the accuracy of directories without contacting the provider. Health plans can use the findings to improve data quality and decide which office locations and other information about a provider to publish in their directories.

MD-Staff now generates CAQH ProView for Groups-compatible rosters that can be submitted to multiple plans at once

WASHINGTON, DC and TEMECULA, CA - 2/28/19

Applied Statistics & Management Inc. (ASM) and CAQH® today announced that they are working together to make it easier for large provider groups to share credentials and other information with health plans. MD-Staff, the ASM flagship credentialing system, now automatically generates rosters that may be uploaded directly into CAQH ProView for Groups, enabling provider organizations to submit information about their providers accurately and efficiently with multiple health plans at once.

WASHINGTON, DC - 1/23/19

Leading managed care plans in Tennessee have adopted CAQH ProView  to increase the accuracy of provider data in the state. Participating plans include Amerigroup Tennessee, BlueCross BlueShield of Tennessee, and UnitedHealthcare.

Opportunity for $12.4 billion in additional savings exists through further automation

WASHINGTON, DC - 1/16/19

CAQH released the 2018 Index today, which reveals that the healthcare industry continues to make progress automating business processes. Electronic adoption and transaction volume increased, with several common transactions reaching 80 percent electronic adoption across the sector. This progress resulted in a narrowing of the cost savings opportunity for the first time in CAQH Index history.

WASHINGTON, DC - 12/13/18

CAQH today announced upcoming advanced new functionality for VeriFideTM, the automated solution that authenticates the accuracy and completeness of credentialing information submitted by healthcare providers to health plans. These latest updates to the primary source verification (PSV) solution offer plans real-time visibility into the credentialing status of each provider throughout the verification process.

WASHINGTON, DC - 11/14/18

CAQH®, an industry alliance working to transform the business of healthcare, today announced that Humana has joined the organization and will serve on the CAQH board of directors.

“We are thrilled that Humana is joining CAQH and will help lead the effort to improve healthcare business processes,” said Robin Thomashauer, President of CAQH. “Humana’s engagement will further advance our mission to make information sharing across the industry more accurate and efficient.”

Industry expert will lead multi-stakeholder efforts to promote efficient, secure electronic data exchange across payment models

WASHINGTON, DC - 10/23/18

CAQH announced that April Todd has joined the organization as Senior Vice President of CAQH CORE and Explorations. In this role, she will be responsible for leading industry efforts to develop and adopt operating rules for electronic transactions across the continuum of fee-for-service (FFS) to value-based payment (VBP). She will also direct CAQH Explorations research functions, including the CAQH Index.

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