CAQH Press Releases | Affordable Quality Health Care Press | News

Federal Employees Health Benefits programs achieve CORE Certification to advance interoperability and seamless electronic data sharing

WASHINGTON, DC - 11/1/17

CAQH CORE®, a collaboration of more than 130 public and private entities across the healthcare industry, has announced that three Federal Employees Health Benefits (FEHB) plans have become CORE-certified. Together, the APWU Health Plan (APWUHP), GEHA and National Association of Letter Carriers Health Benefit Plan (NALC-HBP) cover more than one million federal employees, retirees and their family members.

The ADA® credentialing service, powered by CAQH ProView®, will help reduce repetitive paperwork

Chicago, IL - 10/10/17

In an effort to reduce administrative burdens for all dentists, the ADA and CAQH have formed a strategic alliance to help streamline the credentialing process for dentists, dental plans and employers. The ADA® credentialing service, powered by CAQH ProView®, enables dentists to enter their professional and practice information one time in an easy-to-use, fast and protected digital platform.

WASHINGTON, DC - 6/30/17

CAQH has been named one of the Best Places to Work in Healthcare in 2017 by Modern Healthcare magazine. The organization achieved this honor for the second year in a row.

The “Best Places to Work in Healthcare” recognition program, now in its tenth year, honors workplaces throughout the healthcare industry that empower their employees to provide patients and customers with the best possible care, products and services.

WASHINGTON, DC - 6/28/17

Cynthia West has been named Managing Director, Business Development and Account Management, at CAQH. A senior executive with expertise in both healthcare payer and provider sales and client development, West now oversees all sales and account functions at the organization.

“Cynthia has extensive experience in cultivating strong relationships with both health plans and providers,” said Robin J. Thomashauer, CAQH Executive Director. “She brings a successful track record of strategic team-building and deep knowledge of the healthcare system to CAQH,” she said.  

CAQH Convenes Participants in Industry-Wide Collaboration

WASHINGTON, DC - 6/14/17

A cross-section of healthcare leaders has begun work on a wide-ranging effort to improve the accuracy of provider data for both industry stakeholders and patients. Convened by the non-profit alliance CAQH, the Provider Data Action Alliance will develop a roadmap that articulates a vision and actionable strategies for obtaining and sharing better information. Alliance participants represent health, dental and vision plans; provider organizations; health systems; government; and health information exchanges.

WASHINGTON, DC - 5/8/17

Yuvi Kochar is the new Managing Director, Technology and Operations for CAQH, a non-profit alliance of health plans and trade associations that develops solutions to long-term business inefficiencies in healthcare. Kochar has held senior technology leadership positions across industries, including healthcare, media, education and insurance.

Rapidly growing segment of the healthcare economy turns to CORE Certification to improve electronic data sharing

WASHINGTON, DC - 4/25/17

The CAQH Committee on Operating Rules for Information Exchange® (CORE®) today announced that provider-owned health plans are seeking CAQH CORE Certification to go above and beyond regulatory requirements and improve electronic information sharing. To date, Boston Medical Center Health Plan, Providence Health Plan and UPMC Health Plan have completed testing and have been awarded certifications.

Goal is Industry-wide Sharing of Primary Source Verification Data for Healthcare Providers 

WASHINGTON, DC - 4/4/17

The non-profit alliance CAQH today announced the launch of a new electronic solution, VeriFide, that streamlines primary source verification of the healthcare provider information required for health plan credentialing decisions.

VeriFide will immediately improve the quality, speed and integrity of provider data sent to health plans as part of the credentialing process. Over time, plans will be able to share a common data set of verified information for the providers in their networks, reducing administrative costs by eliminating the need for each plan to manage its own data verification process. The solution will also reduce the administrative burden on providers by decreasing the repetitive requests from multiple plans seeking the same information.

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

WASHINGTON, DC - 3/7/17

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.

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