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The Path Forward for Prior Authorization Reform
Last week’s roundtable discussion hosted by the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) offered a meaningful signal: the healthcare industry is aligning around the urgent need to improve ...
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June 24, 2025
By: CAQH
CAQH Comments to CMS on Health Technology Ecosystem RFI

June 11, 2025
By: CAQH
CAQH CEO Sarah Ahmad Named to Becker’s “100 Women in Health IT to Know” for 2025

May 28, 2025
By: CAQH
Bad Provider Data Is Delaying Care and Driving Up Costs

April 17, 2025
By: CAQH
AI is everywhere in healthcare conversations. But how is it being used?

March 17, 2025
By: CAQH
CAQH Establishes a Provider Advisory Council to Expand Provider Engagement and Advance Healthcare Data Solutions

February 19, 2025
By: CAQH
CAQH Index Report Findings Featured at ViVE 2025

February 11, 2025
By: CAQH
New CAQH Index Reveals $20B Savings Opportunity to Cut Waste, Reduce Costs, and Improve Patient Access

February 6, 2025
By: CAQH
The Cost of Ignoring Women’s Health Extends Beyond Finances: Sarah Ahmad

February 5, 2025
By: CAQH
Podcast: Transforming Healthcare with CAQH - Erin Weber and Don Rucker on Data Quality and Interoperability

January 22, 2025
By: CAQH
CAQH's Ashley Blankette Named to The Top 50 Women Chief Product Officers of 2025

December 4, 2024
By: CAQH
CAQH’s Kristina Rollings Talks Value-Based Care

November 12, 2024
By: CAQH
CAQH and HiLabs Partner to Deliver Industry Leading Provider Data Solutions

November 6, 2024
By: CAQH
Advancing Value-Based Care with Collaborative and Patient-Focused Strategies

November 4, 2024
By: Sarah Ahmad, CEO
Empowering Women Through Menopause with Better Care That Starts with Better Data

November 3, 2024
By: Roy Beveridge, MD Avalere & Sarah Ahmad, CAQH CEO
PODCAST: Using a data-driven approach to human-centered SDOH work

October 18, 2024
By: CAQH
Beyond Directories: The Real Impact of Accurate Provider Data in Healthcare

October 9, 2024
By: CAQH
Navigating Healthcare Data Security: A Roadmap for Health Plans and Their Partners

September 25, 2024
By: CAQH
CAQH Names Ashley Blankette as Chief Product Officer to Lead Provider and Member Data Solutions

August 19, 2024
By: CAQH
A Look at the Changes in RCM that Are Happening Now and Changes that Need to Happen

August 15, 2024
By: Jason Moseley
How to Master Cost Avoidance: Best Practices for COB Data Automation, Ingestion, and Curation

August 13, 2024
By: CAQH
Revenue cycle analytics and how providers can help create best practices for the industry

August 13, 2024
By: CAQH
5 Tips for a Successful Payment Integrity Healthcare Program

June 28, 2024
By: CAQH
Celebrating Pride Month: Our Commitment to Diversity and Inclusive Care

June 24, 2024
By: CAQH
Fierce Healthcare: Payer innovation council weighs improvements to provider data management experience

June 20, 2024
By: CAQH
From HFMA: Engaging in operating rule development and adoption amidst the era of healthcare automation

June 11, 2024
By: Charlene Harrison, Vice President of Operations, CAQH
Transforming Customer Support: The CAQH Approach to Customer Service

May 20, 2024
By: CAQH
Chris Schaefer Appointed as Chief Financial Officer at CAQH

April 30, 2024
By: CAQH
New and Updated CAQH CORE Operating Rules for Healthcare Payments and Claims Processing Efficiency

April 30, 2024
By: CAQH
Exploring the New and Updated CAQH CORE Operating Rules

April 2, 2024
By: CAQH
New CAQH Report Reveals Significant Differences in Administrative Costs

March 4, 2024
By: CORE Team
HHS Recommends CAQH CORE Operating Rules for federal adoption

February 6, 2024
By: CAQH
CAQH Announces an Initiative with Leading Health Plans to Support Healthcare Providers and Improve Data Quality

January 30, 2024
By: CAQH
2023 CAQH Index Report Reveals Transformative Forces

January 11, 2024
By: CAQH
CAQH Announces Kim Koebel as the Organization’s First Chief Operating Officer and Erin Weber as new Chief Policy and Research Officer

August 14, 2023
By: CAQH
CAQH Announces New CEO, Sarah Ahmad

July 20, 2023
By: Olga Khabinskay Healthcare Billing and Management Association and WCH Service Bureau; Randy Gabel OhioHealth; Megan Soccorso Gainwell Technologies; and Mahesh Siddannati Cente
Message from Health Care Claims Subgroup Co-Chairs: Rule Development Update

July 11, 2023
By: CAQH
National Committee on Vital and Health Statistics (NCVHS) Recommends HHS Adopt CAQH CORE Operating Rules

June 29, 2023
By: Michael Alwell VP/CFO Physician Enterprise St. Josephs Health Naveen Maram VP Provider Digital Operations Centene Corporation Michael Pattwell Principal Business Advisor – Val
A Message from the CAQH CORE Value-based Payment Co-chairs: Early Progress and Directions

June 26, 2023
By: CAQH
Data Strategies for Every Health Plan

June 12, 2023
By: CAQH
CAQH Unveils New Brand Highlighting Innovative, Data-Driven Approach to Streamlining Healthcare Administration

June 9, 2023
By: CAQH
Breaking Down Barriers: The Impact of EHR Integrations on Healthcare Efficiency and Care Delivery

June 2, 2023
By: CAQH
CAQH Recognized as Best Place to Work by Modern Healthcare

May 10, 2023
By: CAQH
Two Million Healthcare Providers Trust CAQH Solutions to Securely and Seamlessly Exchange Professional Information with Health Plans and Other Organizations

May 10, 2023
By: CAQH
Improving Price Transparency in Healthcare with the No Surprises Act and the CAQH CORE Eligibility & Benefit Operating Rules

April 19, 2023
By: Morgan Tackett VP Product Management
Three Considerations for Building a Proactive COB Program

February 9, 2023
By: CAQH
The Cost of Customization

February 9, 2023
By: CAQH
Opportunity: Adopting Operating Rules with Attachment Standards

January 31, 2023
By: CAQH
2022 CAQH Index: Health plans and providers can save nearly $25 billion annually by automating administrative transactions

December 20, 2022
By: CAQH
Performant and CAQH Announce Strategic Partnership

November 3, 2022
By: CAQH
A Message from the CAQH CORE Board Chairs: Support for the Proposed Operating Rules for Federal Mandate

September 22, 2022
By: CAQH
What is value-based payment?

July 13, 2022
By: CAQH
3 Challenges and Lessons Learned for FHIR Implementations

June 9, 2022
By: CAQH
Healthcare Leaders Join the CAQH CORE Board

April 26, 2022
By: CAQH
CAQH CORE Awards 400th Certification

April 20, 2022
By: CAQH
New CAQH CORE Operating Rules Improve How Plans and Providers Exchange Information Related to Eligibility and Supplemental Documentation

March 16, 2022
By: CAQH
Improving Health Plan Provider Directories

March 7, 2022
By: CAQH
Why Automated Credentialing is Imperative for the Dental Industry

March 7, 2022
By: CAQH
How Dental Plans Can Improve Provider Data Management

February 15, 2022
By: CAQH
Alleviating the Administrative Burden of Credentialing for Dental Practices

January 31, 2022
By: CAQH
2021 CAQH Index: COVID-Related Challenges Resulted in Increased Adoption of Electronic Business Processes and Greater Opportunities for Future Savings

December 15, 2021
By: CAQH
CAQH Releases New Features to Streamline How Hospitals and Group Practices Manage Directory and Credentialing Information and Share It with Health Plans

November 15, 2021
By: CAQH
Rick Ratliff Joins CAQH Leadership Team

November 9, 2021
By: CAQH
CAQH CORE Releases Industry Guidance on Advanced Explanation of Benefits

September 7, 2021
By: CAQH
CAQH CORE Welcomes Two New Board Members

August 9, 2021
By: CAQH
CAQH Measures COVID-19 Impact on Healthcare Transaction Volumes

July 29, 2021
By: CAQH
AultCare Becomes the First Organization to Earn CORE Recertification

June 30, 2021
By: CAQH
Primary Source Verification Protects Patients

June 29, 2021
By: CAQH
6 Things to Look for When Evaluating a COB Data Source

May 12, 2021
By: CAQH
Provider Directory Accuracy Is Critical for Patient Well Being

April 21, 2021
By: CAQH
CAQH Launches National Directory of FHIR Endpoints and Third-Party Apps

April 7, 2021
By: CAQH
Provider Credentialing: Explained

March 24, 2021
By: CAQH
Coordination of Benefits, Explained

February 25, 2021
By: CAQH
CAQH CORE Launches New Participant Dashboard

February 8, 2021
By: CAQH
Efficient Credentialing Has Never Been More Important for Medicaid Plans

February 5, 2021
By: CAQH
February is National Provider Directory Data Improvement Month

February 3, 2021
By: CAQH
CAQH 2020 Index: Automating Healthcare Administrative Transactions Has Reduced Annual Costs by $122 Billion, $16.3 Billion More Can Be Saved Through Further Automation

January 14, 2021
By: CAQH
New CAQH CORE Operating Rules Improve Connectivity and Accelerate Transition to Value-Based Payments

January 7, 2021
By: CAQH
CAQH Previews Endpoint Directory at Virtual ONC Event

January 7, 2021
By: CAQH
CAQH CORE Approves Operating Rules on Value-based Payments and Interoperability

January 7, 2021
By: CAQH
CAQH Releases Inaugural Pharmacy Services Index

January 7, 2021
By: CAQH
April Todd Interview on Prior Authorizations is AJMC's Most Popular Podcast of 2020

December 15, 2020
By: CAQH
CAQH Study: Initial Results Show Pharmacy Administrative Transactions Are Highly Automated

November 17, 2020
By: CAQH
New CAQH Report: Rural Providers Face Disproportionate Administrative Burdens Associated with Credentialing

November 17, 2020
By: CAQH
CAQH CORE Releases Findings from Industry Survey on Exchanging Medical Documentation

November 17, 2020
By: CAQH
April Todd Discusses Prior Authorization on Change Healthcare Podcast

October 8, 2020
By: CAQH
CAQH Announces Development of National Directory of FHIR Endpoints

October 8, 2020
By: CAQH
CAQH CORE Shares Initial Findings of Prior Authorization Pilot & Measurement Initiative

October 8, 2020
By: CAQH
CAQH Releases Annual Report

October 8, 2020
By: CAQH
CAQH Contributes to Industry Study on Rising Healthcare Costs

August 28, 2020
By: CAQH
CAQH CORE Presents Prior Authorization Operating Rules for Federal Adoption

August 28, 2020
By: CAQH
CAQH Shares Best Practices for Managing Coordination of Benefits in a Crisis

August 11, 2020
By: CAQH
National Lieutenant Governors’ Association Passes Resolution Calling for Administrative Simplification in Healthcare

August 4, 2020
By: CAQH
CAQH Achieves HITRUST CSF Certification for Third Consecutive Year

July 29, 2020
By: CAQH
How It All Began

July 29, 2020
By: CAQH
An Interview with Sorin Davis, Senior Vice President, Industry Relations

July 17, 2020
By: CAQH
CAQH Recognized as Best Place to Work Five Years in a Row

June 24, 2020
By: CAQH
SSI Group, Availity Achieve Additional CAQH CORE Certifications

June 24, 2020
By: CAQH
Re-attestation Critical as Healthcare Organizations Return to Normal

June 24, 2020
By: CAQH
Ensuring Accurate Coordination of Benefits During Remote Work

June 24, 2020
By: CAQH
CAQH CORE Leads Virtual Discussions on Pressing Industry Issues

June 4, 2020
By: CAQH
CAQH Announces Healthcare Industry Veteran Roger Mermelstein as Senior Vice President, Business Development

May 12, 2020
By: CAQH
CAQH Employees Donate iPads to Children’s National Hospital

May 12, 2020
By: CAQH
CAQH White Paper: Simplifying Provider Data Management

May 12, 2020
By: CAQH
CAQH CORE Welcomes Epic to Its Board of Directors

May 12, 2020
By: CAQH
Provider Directories and Access to Care

April 13, 2020
By: CAQH
We Are All in This Together

April 13, 2020
By: CAQH
Streamlining the CAQH ProView Application Process

April 13, 2020
By: CAQH
CAQH ProView: Enhancements in Response to COVID-19

March 10, 2020
By: CAQH
CAQH Hosts Third COB Smart Symposium

February 18, 2020
By: CAQH
Humana Joins Industry Effort to Improve Provider Data and Directories through CAQH DirectAssure

February 4, 2020
By: CAQH
CAQH CORE Approves Two-Day Rule to Accelerate Prior Authorization Process

January 29, 2020
By: CAQH
CAQH Releases 2019 Index

January 29, 2020
By: CAQH
CAQH CORE White Paper: The Connectivity Conundrum

January 29, 2020
By: CAQH
United Healthcare and Optum Earn Phase III CAQH CORE Certification

January 29, 2020
By: CAQH
CAQH ProView: A Year in Review

January 21, 2020
By: CAQH
CAQH 2019 Index: $13.3 Billion, 33 Percent of Healthcare Administrative Spend, can be Saved Annually Through Automation

November 22, 2019
By: CAQH
CAQH Achieves HITRUST CSF Certification

November 22, 2019
By: CAQH
CAQH White Paper: The Hidden Cause of Inaccurate Provider Directories

November 22, 2019
By: CAQH
How Unclear Provider Data Contributes to Unexpected Medical Bills

October 28, 2019
By: CAQH
Presentation Showcases How Medicaid Plans Can Improve Coordination of Benefits

October 28, 2019
By: CAQH
Deadline Extended: Exchanging Medical Documentation Survey

October 28, 2019
By: CAQH
Industry Collaboration Improves Provider Directories

October 28, 2019
By: CAQH
Dental Market Expansion

October 28, 2019
By: CAQH
Industry Progress on Improving Prior Authorizations

September 25, 2019
By: CAQH
CAQH Presents to National Conference of State Legislators

September 25, 2019
By: CAQH
CAQH CORE Comments on Administrative Burdens to HHS and CMS

September 25, 2019
By: CAQH
CAQH CORE and HL7 Announce Collaboration

September 25, 2019
By: CAQH
Moving Medicaid Plans Beyond Pay and Chase

July 31, 2019
By: CAQH
NCQA Finds CAQH Solutions Beneficial in Supporting Accreditation

July 31, 2019
By: CAQH
New CAQH CORE White Paper on Automating Prior Authorization

June 26, 2019
By: CAQH
Leading Health Plans in Texas Adopt CAQH ProView

May 30, 2019
By: CAQH
CAQH CORE Releases Phase V Operating Rules

May 30, 2019
By: CAQH
Easing Access to Provider Directory Data

May 30, 2019
By: CAQH
5 Opportunities to Fix Attachments

May 30, 2019
By: CAQH
Participation in CAQH ProView for Groups Continues to Grow

May 22, 2019
By: CAQH
Texas Health Plans Use CAQH ProView to Improve Provider Data Accuracy

March 26, 2019
By: CAQH
AI Technology is Improving Provider Directories

March 26, 2019
By: CAQH
Recommendations to the Senate HELP Committee

March 26, 2019
By: CAQH
CAQH CORE Awards 350th CORE Certification

February 27, 2019
By: CAQH
Prior Authorization Getting Much Needed Attention

January 30, 2019
By: CAQH
Verifying Provider Credentials is Easier than Ever

January 30, 2019
By: CAQH
Humana Joins CAQH

January 30, 2019
By: CAQH
Collaboration is Improving Healthcare Provider Directories

November 5, 2018
By: CAQH
CAQH CORE Calls for Work Group Participation to Help Improve Prior Authorization Process

November 5, 2018
By: CAQH
CAQH Offers Solutions Suite to Improve Credentialing Process

September 12, 2018
By: CAQH
CAQH CORE Backs Industry Collaboration to Improve Prior Authorization Process

September 10, 2018
By: CAQH
Massachusetts Health Plans Select DirectAssure to Improve Provider Directory Accuracy

July 17, 2018
By: CAQH
CAQH Earns HITRUST CSF Certification, Demonstrating Commitment to Information Security

May 31, 2018
By: CAQH
CAQH Named One of the Best Places to Work in Healthcare for Third Consecutive Year

May 31, 2018
By: CAQH
New Industry Roadmap Recommends Path Toward Sustainable Provider Data System

March 29, 2018
By: CAQH
CAQH CORE Report Highlights Ways to Streamline Value-based Payment Operations

March 28, 2018
By: CAQH
Data Quality Improves with CAQH Directory Management Enhancements

December 18, 2017
By: CAQH
Phase IV CAQH CORE Certification Opens for Prior Authorization and Other Electronic Transactions

December 18, 2017
By: CAQH
CAQH Recognized for Excellence in Health IT by WEDI

December 18, 2017
By: CAQH
Health Plan Strategies to Improve Directory Accuracy

October 24, 2017
By: CAQH
New On-Demand Webinar: Keys to Improving Your Credentialing Process

October 24, 2017
By: CAQH
CAQH Teams with the American Dental Association (ADA) to Simplify Credentialing Process for Dentists

October 24, 2017
By: CAQH
CAQH CORE Issue Brief: Why the Industry Needs to Lead the Way in Streamlining Healthcare Business Transactions

August 16, 2017
By: CAQH
Improving Provider Directory Accuracy in an Evolving Regulatory Landscape

August 16, 2017
By: CAQH
Lessons from UnitedHealthcare and DirectAssure on Improving Provider Directory Accuracy

August 16, 2017
By: CAQH
CAQH ProView Updates Enhance Provider Data and Address Industry Needs

August 16, 2017
By: CAQH
Article in Group Practice Journal Highlights Provider Benefits of CORE Certification

June 12, 2017
By: CAQH
Provider-Owned Health Plans Awarded CORE Certification

June 12, 2017
By: CAQH
CAQH Again Named Best Place to Work in Healthcare

June 12, 2017
By: CAQH
Now Online: 2016 CAQH Annual Report

June 12, 2017
By: CAQH
CAQH Convenes Alliance to Improve Accuracy of Healthcare Provider Data

June 12, 2017
By: CAQH
Gwendolyn Lohse Named One of Most Powerful Women in Healthcare IT by Health Data Management

April 5, 2017
By: CAQH
CORE Exceeds 300 Certifications Milestone

April 5, 2017
By: CAQH
CAQH Provider Directory Solution Demonstrates High Provider Engagement

April 5, 2017
By: CAQH
CAQH Launches New Solution to Improve the Provider Credentialing Process

January 31, 2017
By: CAQH
Integrating User Feedback to Enhance CAQH ProView

January 31, 2017
By: CAQH
New Video Describes Value and Goals of the CORE Certification Program

November 2, 2016
By: CAQH
CAQH-Convened Summit Tackles Provider Data Problems with Industry Leaders

October 26, 2016
By: CAQH
CAQH CORE Town Hall Highlights Progress of Operating Rules and Opportunities Ahead

August 1, 2016
By: CAQH
Health Plan Business Partners Find Value in CAQH CORE Certification

March 8, 2016
By: CAQH
CAQH is Simplifying Provider Directory Maintenance with DirectAssure

November 24, 2015
By: CAQH
More than 200 CORE Certifications Awarded

August 18, 2015
By: CAQH
CAQH CORE Testifies Before HHS Review Committee on Benefits/Challenges of Operating Rules