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.
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CAQH Convenes Participants in Industry-Wide Collaboration
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
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
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
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
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.
CAQH, a nonprofit alliance creating shared initiatives to streamline the business of healthcare, has been selected by Modern Healthcare as one of the 2016 Best Places to Work in Healthcare.
“CAQH is committed to fostering a workplace of excellence where employees are encouraged to offer innovative ideas, make valuable contributions as individuals and support each other’s efforts,” said CAQH Executive Director Robin J. Thomashauer. “This recognition also underlines our commitment to a strong set of values and practices that enable us to attract and retain a stellar workforce.”
Accurate Provider Data Critical to Improving Quality, Costs of Healthcare Delivery
Full industry collaboration is required to develop an effective approach to collecting, maintaining and disseminating accurate, high-quality data from healthcare providers, according to a new white paper from the non-profit alliance CAQH. “Defining the Provider Data Dilemma: Challenges, Opportunities and Call for Industry Collaboration,” will inform the discussion when healthcare industry leaders gather in Washington on Sept. 29 at the 2016 Provider Data Summit, hosted by CAQH, to explore the topic.
Business partners help health plans meet ACA requirements and promote secure and efficient exchange of administrative data
Health plan trading partners are increasingly seeking CORE Certification as a way to help their clients improve administrative processes and meet Affordable Care Act (ACA) requirements, according to the CAQH Committee on Operating Rules for Information Exchange (CORE). CAQH CORE has awarded nearly 300 Certifications to date, nearly half of which are to entities that facilitate efficient electronic transactions for health plans.
New Industry Progress Report Finds Increasing Adoption of Fully Electronic Claims-Related Processes, But Opportunity for Significant Improvement Remains
The U.S. healthcare system is unnecessarily spending billions of dollars each year by continuing to use manual administrative processes for basic transactions, according to the 2015 CAQH Index® released today. Despite steady increases in the industry adoption of HIPAA electronic administrative transactions, the report emphasizes a remaining opportunity to save more than $8 billion each year.