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FAQs & Resources
Frequently Asked Questions
What is the CAQH Index?
The CAQH Index monitors progress and estimated cost savings associated with the adoption of electronic administrative transactions across the healthcare industry, including both health plans and healthcare providers.
What does the CAQH Index measure and track?
The CAQH Index is tracking the transition from a paper-based healthcare system to an electronic one. Industry stakeholders submit data annually to the CAQH Index to help measure adoption and cost savings from common business transactions in healthcare, such as:
- 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
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. Details of the health plan data standards and guidelines for contribution are provided in the CAQH Index Reporting Standards and Data Submission Guides for medical and dental health plans.
How frequently is the 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.
The following overviews are provided for organizations that would like to learn more about the CAQH Index data collection process and the resources typically required:
- Medical Health Plan 2017 CAQH Index Data Collection Process Overview
- Dental Health Plan 2017 CAQH Index Data Collection Process Overview
- Healthcare Provider 2017 CAQH Index Data Collection Process Overview
The resources provided for the 2017 CAQH Index data contribution are below:
- The 2017 CAQH Index Reporting Standards and Data Submission Guides for medical and dental health plans outlines data requirements for numbers of transactions by type, manual vs. electronic, for calendar year 2016.
- The 2017 CAQH Index Data Collection Tool for Payers is provided for medical and dental health plans to submit data for numbers of transactions and costs per transaction, manual vs. electronic, for calendar year 2016.
Please direct any inquiries about participating in the CAQH Index to:
Interim Director, CAQH Explorations