Resources

The CAQH Index is the industry source for tracking health plan and provider adoption of electronic administrative transactions. The CAQH Index is representative of the medical and dental industry as well as pharmacy services.

Below are additional resources and frequently asked questions to help provide more context for the report and organization participation.

Materials

CAQH Index Call for Participants 

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. The CAQH Index is representative of the medical and dental industry as well as pharmacy services. Data is collected and reported annually. 

Which administrative transactions are tracked by the CAQH index?

The CAQH Index tracks common medical, dental and pharmacy administrative transactions:

  • Eligibility and Benefit Verification
  • Prior Authorization
  • Claim Attachments
  • Claim Attachments under Value-based Payment (VBP)
  • Claim Submission
  • Coordination of Benefits (COB) 
  • Claim Status Inquiry
  • Claim Payment
  • Claim Remittance Advice
  • Acknowledgements
  • NCPDP Telecommunications

Reported transactions may vary from year to year based on the data collected.

Who Contributes Data to the CAQH Index? 

Medical and dental health plans, providers, vendors and pharmacy benefit managers (PBMs) contribute data to the CAQH Index.

For the 2020 CAQH Index, data collected from medical plans represented 167 million lives, or approximately 51 percent of covered lives in the U.S. Data submissions from medical plans represented two billion claims and over ten billion total transactions. Data collected from dental plans represented 112 million lives, or approximately 43 percent of covered dental lives in the U.S. Dental data submissions represented 186 million claims and a total of 740 million transactions. Organizations interested in contributing data should click here.

What Data is Collected from Participants? 

Medical and dental plans and pharmacy benefit managers report information on numbers of transactions by type (fully 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, providers and pharmacy benefit managers 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 2021 CAQH Index? 

Data collection will begin in July and end in September 2021. Click here for more information on the 2021 CAQH Index call for participants.

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 a customized 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.

 

Type
Audience
Organization Type
CAQH Program