Programs can quickly identify if members have third party coverage, either through commercial plans or other government programs, make quick and accurate eligibility determinations and answer questions. By reducing the need for enrollee outreach and claims denials, CAQH eliminates costly manual processes and reduces member abrasion.

The solutions integrate with existing Medicaid management systems to simplify implementation and streamline information exchange. With a per member fee, budgeting in predictable and the return on investment is clear.  The unique payer-to-payer communications feature enables programs to collaborate directly with other programs and plans to improve the accuracy and efficiency of eligibility, enrollment and coordination of benefits. 

CAQH member data solutions may be the most accurate and efficient way to coordinate benefits and manage third party liability.  By allowing them to identify other coverage before claims are paid, we help programs avoid millions of dollars in costs and reduce their reliance on costly recovery efforts.