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Improving Operations and Payment Integrity for Medicaid Programs

The CAQH Member Data Solution is a one-of-a-kind resource that is helping Medicaid programs streamline operations, improve enrollee services and advance payment integrity initiatives.

How Nationwide Coverage Data is Transforming State Programs

Every national health plan and many federal and state programs contribute data to the CAQH registry of coverage information and update it weekly. We use this information to help Medicaid programs streamline redetermination, automate operations and lower costs.

Improved Eligibility Determinations

CAQH provides Medicaid programs an analysis of coverage overlap of enrollees, including demographic and contact information, coverage types and dates and payment responsibility.

This information can be used for eligibility, benefit coordination, payment and enrollee outreach activities. A secure payer-to-payer messaging system enables programs to share documents and resolve issues.

8 Pitfalls to Watch Out for in Identifying Third Party Liability


CAQH solutions transform eligibility, enrollment, coordination of benefits and third party liability processes for Medicaid programs.

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