Two million providers and one thousand payers connect, exchange information, and automate critical business processes using CAQH solutions
CAQH today unveiled a refreshed brand and reimagined website that reflects how the organization is delivering data solutions and initiatives to streamline financial and administrative processes in healthcare.
“For more than 20 years, CAQH has evolved to help plans and providers keep pace with changes in the marketplace, policy and technology, and our new, modern brand reflects the value we offer today,” said Robin Thomashauer, CAQH President and CEO. “While our identity is evolving, our mission remains the same. We are more committed than ever to streamlining the business of healthcare, and we are bringing new solutions, initiatives, and resources to this effort.”
CAQH was launched in 2000 to help health plans and providers work together more efficiently and effectively. Today, the CAQH provider data platform enables practitioners and plans representing 80% of covered lives to exchange data for credentialing, directory and network management and other essential purposes. This industry-wide approach reduces administrative burden for providers while streamlining operations and improving data quality for plans.
In 2013, CAQH launched an initiative to help payers coordinate benefits to reduce inaccurate claims payments and recovery costs. Today, the CAQH member data platform includes coverage information on over 200 million members, updated by health plans every week. It is a one-of-a-kind resource to improve payment integrity and eligibility for commercial and public sector payers.
Together, these provider and member data solutions are reducing redundant processes, improving the experience for providers and members and accelerating healthcare transformation. Given the unique role CAQH plays in the industry, no other partner can or does manage this volume of data from the original sources – the providers and plans themselves.
CAQH CORE has brought industry stakeholders together to develop Operating Rules that have improved the way plans and providers verify eligibility, bill and pay claims, conduct prior authorizations and perform other administrative transactions that occur millions of times every day. CAQH Insights tracks the industry’s progress toward becoming more efficient and automated and identifies areas for improvement.
“CAQH plays a unique role in healthcare, facilitating engagement between health plans and providers in every specialty and region across the country,” said Brian D. Pieninck, President and CEO of CareFirst BlueCross BlueShield and CAQH Board Chair. “Their efforts to rebrand will elevate how they add value through leveraging data assets and expertise in new ways to make our healthcare system work better for the industry and those we mutually serve, who are counting on our organizations to get this right.”
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