CAQH today released the first CAQH Pharmacy Services Index, a report that examines levels of automation among pharmacy benefit managers (PBMs) for three common administrative transactions. This initial research suggests that PBMs generally conduct a higher percentage of these transactions electronically than medical plans, likely due to different workflows, volumes and levels of transaction complexity.
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CAQH Pharmacy Services Index examines administrative workflows and opportunities for further automation of the pharmacy sector
Solution will facilitate how health plans, Medicaid agencies and third-party apps find and share technology connections to provide consumers greater access to their healthcare data
CAQH today announced the development of a centralized directory of validated payer FHIR endpoints and third-party applications. This solution will simplify how healthcare organizations and app developers connect with each other to help consumers access and transfer their healthcare information.
Certification underscores CAQH commitment to the higest standard of protecting sensitive private healthcare information
CAQH today announced that Roger Mermelstein has joined the organization as Senior Vice President, Business Development. In this role, he will lead sales and account management for the non-profit alliance’s health plans and other participating organizations, and serve on the CAQH leadership team.
An accomplished executive with a proven track record building high performing teams, Mr. Mermelstein is recognized across the healthcare industry for his ability to develop long-term client relationships built on trust and exceptional service.
CAQH, an industry alliance working to transform the business of healthcare, today announced that Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, has joined other national health benefits companies in the effort to improve the accuracy of health care provider directories by participating in CAQH DirectAssure®.
Over 80 percent of industry stakeholders agree to time limits on requests for supporting information and final determinations on prior authorizations
CAQH CORE, a multi-stakeholder organization representing a broad spectrum of health plans, providers, vendors, and government entities, has voted to set two-day time limits on how quickly health plans must request additional supporting information from providers and make final determinations on prior authorization requests.
Of the $350 billion widely cited as the cost of administrative complexity, $40.6 billion is spent on eight business transactions
CAQH® today released the seventh annual report measuring the progress made by the healthcare industry in reducing the costs and burden associated with administrative transactions through automation. The 2019 CAQH Index found that, of the $350 billion dollars widely cited as the cost of administrative complexity in the US healthcare system, $40.6 billion is spent on eight administrative transactions.
Streamlining the way directory information is collected and shared with health plans can improve accuracy and save physician practices more than $1.1 billion
CAQH® today released results of a survey of providers across the US that revealed the administrative burden associated with maintaining provider directories. The survey of 1,240 physician practices, conducted in September 2019, determined that directory maintenance costs practices nationwide $2.76 billion annually.