FAQs & Resources

Frequently Asked Questions

What is the CAQH Index?

The CAQH Index is the industry source for tracking health plan and provider adoption of electronic administrative transactions. It also estimates the industry cost savings opportunity, an amount that declines as adoption and efficiency grows

What does the CAQH Index measure and track?

The CAQH Index measures the number of claims-related healthcare business transactions conducted between health plans and healthcare providers and the methods used to complete these transactions. The Index calculates and tracks medical and dental industry adoption and cost benchmarks that help individual companies, industry organizations, government and others understand how the transition to fully electronic administrative transactions is progressing. The Index currently measures 13 common administrative transactions:

  • Claim Submission
  • Eligibility Verification
  • Prior Authorization
  • Claim Status
  • Claim Payment
  • Claim Remittance Advice
  • Claim Attachments
  • Prior Authorization Attachments
  • Coordination of Benefits (COB) Claim Submission
  • Referral Certification
  • Enrollment and Disenrollment
  • Premium Payment
  • Acknowledgements
Who contributes data to the CAQH Index?

Both health plans and healthcare provider organizations may contribute data. Health plans report information on numbers of transactions by type (electronic, telephone, fax etc.), as well as information on costs of those transactions. Participating healthcare provider organizations (facilities and medical groups) report on costs of transactions only. Organizations may learn more about contributing data to the CAQH Index at any time by contacting the CAQH Index lead researcher. 

How frequently is CAQH Index data collected, compiled and released?

Data is collected and reported annually. Participating industry stakeholders submit data each year during the data submission period defined by the CAQH Index.

How is CAQH involved in the Index?

The Index, which was initially developed and owned by Emdeon (now Change Healthcare), is now owned and operated by CAQH. CAQH is committed to ensuring that the Index continues to be a meaningful tool for all industry stakeholders. Moving forward, the CAQH Index will continue to refine current measures, examine opportunities to measure progress from the perspectives of additional stakeholders and expand the scope of its annual transaction data collection.

Why should my organization contribute data to the CAQH Index?

CAQH Index data contributors receive customized individual reports enabling a deeper analysis of organizational performance alongside national results for benchmarking and cost savings opportunities. By participating as a data contributor, organizations at every stage of adoption can help improve the overall quality of data, enabling deeper Industry insight into the transition and helping ensure findings are an accurate reflection of progress and cost savings.

Multi-stakeholder participation in the CAQH Index helps the industry achieve its goal to make healthcare more affordable through the development and implementation of benchmarks to track the efficiency of administrative transactions.

How do I participate in the CAQH Index?

Organizations may express interest in contributing data to the CAQH Index at any time by contacting the CAQH Index lead researcher. Once participation begins, organizations will receive data submission instructions and unique data submission tools.

 

Please direct any inquiries about participating in the CAQH Index to:

Kristine Burnaska
Director, Research and Measurement 

 

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