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CAQH Index Advisory Council
The CAQH Index Advisory Council represents organizations across the healthcare industry, including medical and dental plans and providers, vendors/clearinghouses, government ad research experts. The role of the Council is to:
- Advise CAQH on research measures;
- Represent unique indistry perspectives to enhance findings and future reports; and
- Promote industry participation in the CAQH Index.
CAQH Index Advisory Council Roster
|Advisory Council Member||Organization|
|Krishna Aravamudhan||American Dental Association|
|John Bialowicz||Blue Cross Blue Shield of Michigan|
|Terrence Cunningham||American Hospital Association|
|Lorraine Tunis Doo||Centers for Medicare & Medicaid Services|
|Jay Eisenstock||JE Consulting|
|Tab Harris||Florida Blue|
|Chris Koopman||Healthcare Financial Management Association|
|Suzanne Lestina||University of Chicago Medical Center|
|Diana Lisi||UnitedHealth Group|
|Sonya R. May||UnitedHealth Group|
|Thomas L. Meyers||America's Health Insurance Plans|
|Stanley Nachimson||Nachimson Advisors, LLC|
|Craig Seiler||Experian Health|
|Elizabeth Templeton||Florida Blue|
|Robert M. Tennant||Medical Group Management Association|
CAQH Index Advisory Council Biographies
Dr. Krishna Aravamudhan has been employed by the American Dental Association (ADA) for 17 years and, since 2014, in the position of director for the Council on Dental Benefit Programs, directing and overseeing all of the program activities of the Center for Dental Benefits, Coding and Quality. It is in this position that she oversees the ADA’s Credentialing Service powered by ProView, the work of the Dental Quality Alliance, the CDT Code and third party payment programs.
In the past she has also served as the Associate Director of the ADA’s Center for Evidence Based Dentistry where she led the development of clinical guidelines and managed the EBD Website and critical summaries. Dr. Aravamudhan graduated from the Bangalore University, India with her dental degree and followed it with a Master of Science from the University of Alabama at Birmingham School of Dentistry.
John Bialowicz manages the EDI operations and all-payer clearinghouse at Blue Cross Blue Shield of Michigan, and has 30 years of experience working with providers, vendors, trading partners, and payers to reduce cost and increase volumes of electronic transactions. Bialowicz began his career at BCBSM marketing Practice Management Systems to professional and facility providers, providing him and excellent perspective to provider’s workflows and their day-to-day challenges.
Bialowicz recently joined the DaVinci Project, and has participated in a number of industry organizations, WEDI (Workgroup for Electronic Data Interchange), including sub workgroup for e-attachments, NDEDIC (National Dental EDI Council), HITSP (Healthcare Information Technology Standards Panel) and is currently working with MIHIN (Michigan Health Information Network) to expand statewide clinical transactions. He earned a Bachelor’s in Business Administration from the University of Michigan.
Terrence Cunningham is the Director for Administrative Simplification Policy with the American Hospital Association. In this role, Terrence engages in regulatory and legislative initiatives associated with the HIPAA Administrative Simplification provisions, as well as other activities designed to reduce administrative complexities and billing issues for hospitals. Additionally, Terrence’s responsibilities include developing and maintaining the UB-04 Data Specifications Manual (UB-04 Data Set) and serving as the Chairman to the National Uniform Billing Committee (NUBC).
Prior to joining the AHA, Terrence served as a Senior Policy Analyst with the American Medical Association. In this role, Terrence’s work focused on regulatory and policy developments affecting physician revenue processes.
Lorraine Tunis Doo is the Senior Policy Advisor for the Division of National Standards at the Centers for Medicare & Medicaid Services (CMS). She provides policy guidance on regulatory issues pertaining to the provisions of the Health Insurance Portability Act of 1996 (HIPAA) and the Patient Protection and Affordable Care Act of 2010 (ACA) – specifically the adopted transaction standards, code sets, identifiers and operating rules exchanged between providers and health plans to conduct business operations. Lorraine also leads an intra-agency collaboration on interoperability at CMS. She is the lead staff for the Standards Subcommittee of the National Committee for Vital and Health Statistics, the Federal Advisory Committee (FACA) to the Secretary. In the past, Lorraine launched the agency’s foray into Personal Health Records and the BlueButton for Medicare, which has grown up to become the MyhealthEData initiative, leveraging the benefits of the HL7 FHIR standard. She is co-chair of the HL7 Personal Health Record System Functional Model work group and continues to be active in many industry work groups. Lorraine served in a variety of training and industry liaison roles for the first 18 months of the Affordable Care Act implementation at CMS.
Prior to joining CMS in 2003, Lorraine was the director of a 100,000 member statewide Medicaid managed care organization run by a private insurance company in Maryland. Lorraine holds a Master in Social Work Administration and a Master in Gerontology, both from the University of Michigan, and a Master of Public Health from the Johns Hopkins School of Public Health.
Jay Eisenstock is a seasoned consultant, speaker, contract negotiator and management professional with more than 30 years of recognized experience in healthcare and technology. Jay combines a solid foundation of business expertise with a strong technology background and is focused on achieving superior bottom-line results for his clients.
Jay has a demonstrated track record of managing strategic partnerships and delivering large-scale, mission-critical projects on time and within budget. Throughout his career, Jay has leveraged a team-based management style and interpersonal communication skills to guide all levels of internal and external customers. Jay has negotiated strategic contracts in excess of $120M annually and played a crucial role in performing due diligence measures in the evaluation of corporate acquisitions.
Jay received his MBA from the University of Massachusetts and his Bachelor of Science degree from Rochester Institute of Technology. He is active in the industry serving as Board Chair for the Workgroup for Electronic Data Interchange (WEDI), a Commissioner for the Electronic Healthcare Network Accreditation Commission (EHNAC) and on several committees with the Council for Affordable Quality Healthcare (CAQH).
Among Jay’s previous accomplishments, he was recognized by Healthcare Payer News as one of 11 top executives and thought leaders in the healthcare IT industry, a finalist for Aetna’s highest employee recognition award, and won the WEDI Leadership in Technology award. He was also the 2017 recipient of the prestigious WEDI Andrew J. Melczer Leadership award.
Tab Harris is the Director of Provider Connectivity Solutions and EDI Operations at Florida Blue and is accountable for all provider e-capabilities including HIPAA and HL7 transactions in addition to portal based capabilities. Florida Blue has been recognized as an industry leader and model for gateway management and mandate implementations.
Harris has 24 years of commercial and Medicare health payer experience at Florida Blue and its associated organization, First Coast Service Options and has worked the last 16 years in the electronic data interchange space. Harris is a frequent attendee and is occasionally asked to present at organized and standards workgroup meetings. He attends and is a voting member at HIMSS, WEDI, X12 and other Opal sponsored events.
Joe Hendrickson serves as the Vice President of Customer Success at athenahealth.
Paul Keyes is a Product Manager for Cigna Provider Digital Solutions. He has been responsible for Cigna's provider connectivity strategy since 1992. Keyes has worked at Cigna for 36 years with management roles in Operations, Compliance, EDI and EDI Vendor strategy and management.
Keyes has extensive industry workgroup experience, including the NEIC Payer Advisory Board Member 1991–1995, WEDI Board Member 1995-1999, Phase III CAQH CORE operating rule development, and serving as the Cigna lead for CAQH EFT enrollment and the CAQH Index.
Chris Koopman is a policy analyst on HFMA’s Healthcare Finance Policy team. HFMA delivers education, analyses, and strategic and tactical guidance to its membership of executive and financial management leaders from provider organizations, physician practices, and health plan markets. Chris works on numerous healthcare finance topics and thought leadership efforts, with special attention paid to the revenue cycle. He leads HFMA’s Revenue Cycle High Performance Award submission collection and review process and is a co-author on multiple HFMA whitepapers including an analysis of the impact of transfer cases on Academic Medical Centers and Health System M&A on quality and financial performance. Chris has worked in the healthcare industry for 12 years. Prior to joining HFMA, he held roles at Sanford Health and Rush University Medical Center in clinical data & quality analysis, corporate compliance & audit, and revenue cycle process improvement.
Suzanne advises AHA leadership on the best strategic future course for administrative transactions, given the move toward value and other changes in the broader health and technology landscape, with a view toward efficiency and burden reduction. In her role at AHA, Suzanne serves as chair of the National Uniform Billing Committee (NUBC), a multi-stakeholder group whose purpose is to review and approve a billing data set capable of supporting the HIPAA administrative transaction standard for billing (the UB-04 Data Set).
Prior to her role at AHA, Suzanne was actively involved in healthcare transformation and innovation, where she engaged health system leaders with forward-thinking concepts, strategies and trends in revenue cycle management and patient financial experience as the VP of Revenue Cycle Innovation for Avadyne Health. In addition, Suzanne was HFMA’s Director of Revenue Cycle where she advised health systems on revenue cycle performance improvement and was the MAP product line expert. Suzanne has held revenue cycle leadership roles in the Chicago area as well as revenue cycle management consulting on a national level. She has a bachelor’s degree in organizational management from Concordia College and is a past president of the 1st Illinois Chapter of HFMA.
Diana Lisi is the Director of EDI Integration Services for UnitedHealthcare. Diana has worked in the Healthcare Industry nearly 20 years. The majority of her career has been spent specializing in electronic healthcare transactions. Diana is an active participant in a number of industry consortiums focused on increased utilization of administrative transactions and Provider Self Service. Native to Connecticut, Diana holds a Finance Degree from Fairfield University.
Sonya is an EDI Compliance Analyst/EDI Industry Engagement Coordinator/Attachment Product Owner at UnitedHealthcare.
Thomas L. Meyers is a Vice President with America's Health Insurance Plans (AHIP). AHIP is a national trade association representing member companies that provide health benefits to more than 200 million Americans. His industry experience provides insight and direction from a perspective developed as an executive in the group benefits business with a proven track record of successfully implementing business strategies focused on market expansion and bottom-line growth. Process alignment, product development, product management, marketing, operations, and strategic and tactical planning have been key areas of focus.
Before joining AHIP, Tom held a variety of executive and management level positions at Travelers Insurance Company and Mutual of Omaha. He currently serves on the Workgroup for Electronic Data Interchange (WEDI) Board of Directors. Tom earned a Bachelor's degree in finance from Siena College.
Stanley Nachimson is Principal of Nachimson Advisors, LLC, a health IT consulting firm dedicated to finding innovative uses for health information technology and to encouraging its adoption. Nachimson is focused on assisting healthcare providers and plans with ICD-10 implementation.
Nachimson is retired from the U.S. Department of Health and Human Services, where he served for more than 30 years in a variety of statistical, management, and health technology positions. While there, he developed HIPAA policy, regulations, and implementation planning and monitoring, beginning the CMS work on Personal Health Records, and serving as the CMS liaison with several industry organizations, including the Workgroup for Electronic Data Interchange (WEDI) and the Healthcare Information Technology Standards Panel (HITSP). He currently is the director of the North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA)-WEDI Timeline Initiative and serves QualEDIx Corporation as a member of its Board of Advisors. He earned a Master's degree in applied statistics from The George Washington University.
Amy Neves is Director of EDI Transaction and Regulatory Support at Aetna. Neves promotes effective EDI industry standards by expressing Aetna's viewpoints to influence decisions and representing Aetna as an industry leader in their adherence to and compliance with these standards. In her role, Neves collaborates with a wide array of business stakeholders, technical and testing counterparts to deliver 25-50 technical projects and service requests each year, focuses on impact and value add of regulatory requirements and recognizes the impact of new work on current and planned solutions.
Ryan Reddick has over 20 years of professional experience in Digital healthcare IT concentrated in the areas of E-Commerce, Portal, mobile technologies and Electronic Data Interchange (EDI). Over the past 15 years Mr. Reddick has provided expertise in quality and strategic planning to Healthcare organizations helping them utilize information technology to improve clinical and administrative activities. He has served as guest lecturer and consultant on topics including Digital strategies & development, clinician adoption of information technology, quality improvement and managed care.
Mr. Reddick is currently the VP of E-Solutions Anthem, Inc. In this role, he is responsible for digital strategic planning and development, corporate compliance, standards development and emerging capabilities of all e-channel transactions including EDI and Provider Portal. Mr. Reddick also serves as the electronic standards ambassador and advisor to promote effective governance and consistent solutions and customer experiences through all Anthem digital/E-channel transactions. From 2009 to 2014, Mr. Reddick was Director of Enterprise EDI Programs for Anthem, responsible all Operations, Development, and support of EDI transactions and systems for all Anthem health plans throughout the enterprise.
Prior to his responsibilities at Anthem, Mr. Reddick was a Principal Consultant and Systems Engineer with EDS/HP centering on EDI enablement and Medicaid Management Information System (MMIS) Implementation. Preceding his work at EDS, he served as Manager of Provider Relations at Heartland Health Plan of Oklahoma under administration of Schaller Anderson, Inc.
Ryan has a BS of Mechanical Engineering from the University of Tulsa and a BS of Management Information Systems from Oklahoma State University. He has obtained certifications as a Project Management Professional (PMP), Certified Six Sigma Black Belt (CSSBB) and Agile Coach (ICPACC). He also serves on the WEDI Board of Directors.
Craig Seiler is the Director of Healthcare Payer Relations at Experian Health. Prior to his role at Experian, he spent 24 years as the Director of Operations and Support for Change Healthcare where he was responsible for driving revenue and managing expenses.
Elizabeth Templeton is an EDI Consultant of Provider Connectivity Solutions at Florida Blue.
Robert Tennant is Director of Health Information Technology Policy for the Medical Group Management Association (MGMA). In his role at the association, Mr. Tennant focuses on federal legislative and regulatory health information technology issues including MACRA, HIPAA Privacy and Security, administrative simplification, EHR policy, and other HIT topics. Mr. Tennant currently participates with numerous industry organizations including his position on the executive committee of the Board of Directors of the Workgroup for Electronic Data Interchange (WEDI); and co-chair of the WEDI Virtual Clipboard Initiative, Secure Messaging Workgroup, and ePayments Taskforce. In addition, he serves as co-chair of the National HIPAA Summit, is a member of the CMS DRLS workgroup, Board of Commissioners for the Electronic Healthcare Network Accreditation Commission (EHNAC), the United Healthcare Administrative Simplification Workgroup, the National Uniform Claim Committee, the Physicians EHR Coalition, and others. Mr. Tennant was named as one of HealthData Management magazine’s “Top 30 Health IT Experts to watch in 2019.”
Beth Wolskij is the Director of Clearninghouse Product Management with Experian Health.