CAQH today released the first CAQH Pharmacy Services Index, a report that examines levels of automation among pharmacy benefit managers (PBMs) for three common administrative transactions. This initial research suggests that PBMs generally conduct a higher percentage of these transactions electronically than medical plans, likely due to different workflows, volumes and levels of transaction complexity.
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CAQH today announced the development of a centralized directory of validated payer FHIR endpoints and third-party applications. This solution will simplify how healthcare organizations and app developers connect with each other to help consumers access and transfer their healthcare information.
CAQH Announces Healthcare Industry Veteran Roger Mermelstein as Senior Vice President, Business Development
CAQH today announced that Roger Mermelstein has joined the organization as Senior Vice President, Business Development. In this role, he will lead sales and account management for the non-profit alliance’s health plans and other participating organizations, and serve on the CAQH leadership team. An accomplished executive with a proven track record building high performing teams, Mr. Mermelstein is recognized across the healthcare industry for his ability to develop long-term client relationships built on trust and exceptional service.
CAQH, an industry alliance working to transform the business of healthcare, today announced that Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, has joined other national health benefits companies in the effort to improve the accuracy of health care provider directories by participating in CAQH DirectAssure®.
CAQH CORE, a multi-stakeholder organization representing a broad spectrum of health plans, providers, vendors, and government entities, has voted to set two-day time limits on how quickly health plans must request additional supporting information from providers and make final determinations on prior authorization requests.
CAQH 2019 Index: $13.3 Billion, 33 Percent of Healthcare Administrative Spend, can be Saved Annually Through Automation
CAQH® today released the seventh annual report measuring the progress made by the healthcare industry in reducing the costs and burden associated with administrative transactions through automation. The 2019 CAQH Index found that, of the $350 billion dollars widely cited as the cost of administrative complexity in the US healthcare system, $40.6 billion is spent on eight administrative transactions.
Leading health plans across Texas are adopting CAQH ProView® to improve the accuracy of provider data. Participating plans in the state include Amerigroup, Superior HealthPlan and UnitedHealthcare, whose combined membership represents nearly 4 million Texans and more than 50% of the Medicaid covered population.