The Benefit Enrollment transaction (834) is used by employers, as well as unions, government agencies or insurance agencies, to enroll members in a healthcare benefit plan. The CAQH CORE Benefit Enrollment Operating Rules support consistent infrastructure and a connectivity safe harbor across the industry.
For years, inaccurate provider directory data has been a concern for the healthcare industry - causing frustration for health plans and providers, and potentially creating barriers to care. As CAQH highlighted in the white paper The Hidden Causes of Inaccurate Provider Directories, one of the causes of directory errors is the administrative burden practices face when responding to a high volume of health plan requests for information and updates.
Provider data drives the most fundamental processes in the healthcare system. The industry uses provider data to connect patients with healthcare providers, license practitioners, exchange information and pay for services. Though the industry spends more than $2 billion annually to maintain provider data, inaccuracies and inefficiencies persist.
A variety of factors contribute to poor quality provider data, such as the proliferation of proprietary platforms and technologies.
Epic, an industry-leading software provider, has become the newest member of the CAQH CORE Board. Founded in 1979, Epic now handles medical records for more than 250 million people worldwide through its catalogue of software platforms. Their technology is widely used in hospitals, retail clinics, independent practices and academic medical centers, among other settings.
CAQH employees have come together—virtually—to show their support for healthcare workers on the frontlines of COVID-19. Responding to Children’s National Hospital’s urgent need for iPads compatible with systems in their containment area, treatment rooms and other facilities, team members from across CAQH collected enough funds to donate thirty devices. The iPads have been put to immediate use by emergency department doctors.
CAQH is proud of and inspired by its employees and the generosity they have shown during this difficult time.
Our nation’s healthcare system is being tested like never before. In the fight against COVID 19, healthcare workers are putting their lives on the line around the clock. Health plans are doing everything possible to expand access, remove barriers and support those delivering care.
At CAQH, we want to say thank you to all of those who are working so hard and sacrificing so much.
At CAQH, we continuously search for new ways to streamline administrative processes for providers, health plans and other participating organizations. To simplify how providers complete their initial profile, the CAQH ProView application will no longer require the Attestation Authorization and Releases (AARs) to be hand signed. Beginning immediately, we will also accept computer-generated signatures.
The following CAQH ProView® releases will be effective April 20, 2020:
License Upload Requirements Follow Changes in FSMB Rules
In response to COVID-19, the Federation of State Medical Boards (FSMB) relaxed rules regarding physician licensure during the State of Emergency, extending physician renewal dates as much as 90 days after the end of the emergency, varying by state.
X12 and CAQH CORE will host the Introduction to the 278 Transaction, Standard and Operating Rules webinar on April 30 at 2:00 pm ET. During this session, experts from both organizations will provide insights into how to utilize this transaction to electronically submit prior authorization and referral requests. They will also discuss how CAQH CORE Operating Rules for Prior Authorizations can further standardize components of this process across healthcare.
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