Accurate Provider Data Critical to Improving Quality, Costs of Healthcare Delivery

WASHINGTON, DC -

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

WASHINGTON, DC -

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

WASHINGTON, DC -

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.

Leader in Provider Data Enables 1.3 Million Providers to Use Self-Reported Information in CAQH ProView to Meet New Regulations

WASHINGTON, DC -

The non-profit alliance CAQH today announced a new, fully-electronic solution to improve the quality of provider data in health plan directories. Launching as regulatory requirements increase for accurate provider directory information, DirectAssure is designed to help relieve the associated burden on healthcare providers.

CORE Certification becomes the gold standard for electronic healthcare data exchange

WASHINGTON, DC -

The CAQH Committee on Operating Rules for Information Exchange (CORE®) today announced that it has awarded more than 200 CORE Certifications to health plans, hospitals and health systems, clearinghouses and vendors.  Widely regarded as a must-have seal of approval across the healthcare industry, CORE Certification signifies that these organizations follow a set of HIPAA-mandated standards and operating rules for exchanging electronic administrative data.

CAQH CORE Announces Phase IV Package for Claims, Prior Authorization, Employee Premium Payment, Enrollment and Disenrollment

WASHINGTON, DC -

The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today announced the approval of the Phase IV CAQH CORE Operating Rules package for four healthcare business transactions: healthcare claims; prior authorization; employee premium payment; and enrollment and disenrollment in a health plan.

WASHINGTON, DC -

 To ease credentialing for Illinois physicians, the Council for Affordable Quality Healthcare (CAQH), today announced the launch of its Universal Credentialing DataSource system in the state. CAQH, a not-for-profit alliance of the nation's leading health plans and networks, developed this free service to help physicians more easily and cost-effectively provide required credentialing information to health care organizations under the Illinois Health Care Professional Credentials Data Collection Act.

Change to Drive Expanded Participation and Support Shift to Mandated Environment for Operating Rules Development

WASHINGTON, DC -

CAQH® today announced that a Transition Committee has been launched to make recommendations regarding multi-stakeholder governance of the Committee on Operating Rules for Information Exchange® (CORE®). The Transition Committee was formed as part of a 2010 commitment made by the CAQH board to increase industry participation in operating rules development and adoption. The Committee is charged to develop a three-year governance plan that outlines structure and revenue models for CORE.

Data Refresh Every 120 Days Makes UPD One of the Most Reliable and Trusted Provider Resources Nationwide

WASHINGTON, DC -

CAQH® announced today that more than 800,000 physicians and other healthcare professionals are actively engaged in the voluntary industry-wide effort to reduce excessive paperwork and associated costs by using its online Universal Provider Datasource® (UPD).

WASHINGTON, DC -

DecisionHealth, a leading source for health care news, analysis and instructional guidance, announced today that it will be including CAQH, a nonprofit alliance of health plans and trade associations aimed at simplifying health care administration, to enhance onsite training at the 14th Annual National Provider Enrollment Workshop 2014: Solve your Medicare and Commercial Payer Enrollment Challenges.