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For Health Plans
CAQH data solutions help plans streamline operations, reduce costs, gain insights and deliver a better experience to providers and members.
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Better data for better decisions.

With advanced analytics and a one-of-a-kind database of provider and member information, CAQH data solutions allow payers to make more informed decisions and transform business processes.

Improved network relations

CAQH reduces the need for plans to contact practices to obtain and update credentialing and directory information. This reduces administrative burdens on providers and improves network relations.

Automated and efficient processes

The CAQH cloud-based platform automates business processes, replaces labor intensive provider outreach and reduces administrative costs.

 

Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabama

Proven Tactics for Improving Your Provider Credentialing Process

Data driven

CAQH collects, verifies and manages the industry’s most extensive, up-to-date and trusted source of healthcare data. We harnesses the scale and accuracy of its data to enable participating organizations to streamline operations, reduce costs, and transform business processes.

 

The CAQH provider data platform includes credentialing, demographics, practice information and other data on 2 million healthcare practitioners in every state.  Because this information is regularly submitted, updated and confirmed by the providers themselves, it is the most comprehensive and accurate data source of its kind. The CAQH registry of healthcare coverage information on 200 million members is an unmatched tool for ensuring payment integrity.

 

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Technology forward

CAQH everages the latest technology to enable payers, providers, vendors and developers to connect and exchange information seamlessly and securely. Our cloud based platform uses machine learning and proprietary algorithms to verify and enhance the precision of information submitted by providers. 

 

Together, these solutions advance federal, state and industry initiatives on interoperability and improve how health plans collect, validate and manage mission critical information.

 

2.4M
providers have completed a provider data profile
1.4M
providers have attested within 120 days
73%
of US Physicians have a complete profile
101K
US Dentists have a complete profile

Industry endorsed

 

Practitioners in every state and most specialties regularly log in to CAQH solutions to store, manage and share data. Health plans that serve 9 out of 10 commercial lives rely on CAQH to streamline business processes, access a wealth of accurate and actionable data, and deliver a better experience to both providers and members. 

 

"Accessing quality data is fast and easy. The credentialing solution has improved our credentialing process tremendously."

 

Credentialing Specialist Lead

"The COB solution sells itself! Add to that a transparent pricing model and outstanding service and technical support, and you've got a winning combination!"

 

Team Lead – COB & Medicare Claims

"My account manager had an understanding of our unique needs and was able to translate that insight to support our directory management and credentialing initiatives."

Supervisor, Provider Operations

Trusted and Proven

 

For more than 20 years, many of the nation's most respected healthcare payers have partnered with CAQH to identify industry-wide business challenges and develop data driven solutions. 

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Reduce provider abrasion. Manage networks more efficiently. Maximize internal resouces.

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