Resources

The CAQH Index is the industry source for tracking health plan and provider adoption of electronic administrative transactions. Below are additional resources and frequently asked questions to help provide more context for the report and organization participation.

Materials

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. Data is collected and reported annually.

Which administrative transactions are tracked by the CAQH index?

The Index currently tracks 12 common administrative transactions:

  • Eligibility & Benefit Verification
  • Prior Authorization
  • Prior Authorization Attachment
  • Referral Certification / Approval
  • Claim Submission
  • Coordination of Benefits (COB) / Crossover Claim
  • Claim Attachment
  • Claim Status Inquiry
  • Claim Payment
  • Enrollment / Disenrollment (Employer/HIX/Broker)
  • Remittance Advice
  • Acknowledgements

Who Contributes Data to the CAQH Index? 

Medical and dental health plans and providers contribute data to the CAQH Index.

For the 2018 Index, data collected from medical plans represented 160 million lives, or approximately 49 percent of covered lives in the U.S. Data submissions from medical plans represented nearly 1.6 billion claims and over 7.8 billion total transactions. Data collected from dental plans represented 106 million lives, or approximately 44 percent of covered dental lives in the U.S. Dental data submissions represented over 730 million transactions. Organizations interested in contributing data should click here.

What Data is Collected from Participants? 

Medical and Dental plans report information on numbers of transactions by type (electronic, partially electronic or manual), as well as information on costs of those transactions. Participating medical and dental providers report on cost and time of transactions. Plans and providers may learn more about contributing data to the CAQH Index at any time by clicking here.

HOw frequently is cAQH Index data collected and ReporteD? 

Data is collected and reported annually. Ad hoc reports are released throughout the year.

When will data collection begin for the 2019 Index? 

Data collection will begin in April and end in August 2019.

How do I participate in the CAQH Index? 

Organizations can express interest in contributing data to the CAQH Index by clicking here

Why Should my Organization contribute data to the CAQH Index? 

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 from manual to electronic administrative transactions. Data contributors also receive customized a report comparing organizational performance to national results for adoption and cost savings opportunities.

How is CAQH involved in the Index? 

Since 2011, CAQH has owned and operated the Index. CAQH currently partners with NORC at the University of Chicago to assist with the provider data collection and analyses.

CAn I get a copy of the CAQH Index? How much does it cost? 

Yes. You can download a complimentary copy of the CAQH Index on the website here.

Can I use CAQH Index data in my presentation, blog, newsletter, etc? 

Yes. We just ask that you cite the CAQH Index report.

Does CAQH Have someone who can speak on the Index at our event? 

Yes. For speaking engagements, please email explorations@caqh.org.

I missed the annual webinar. Is it available online? 

Yes. Please find the most recent CAQH Index webinar recording and slides here.

 

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