About Caqh
CAQH is a non-profit alliance of health plans and related associations that aims to simplify the business of healthcare. The organization was founded in 1998 with the goal of creating a more efficient and effective healthcare system by reducing administrative burdens for both providers and payers.
With over 1,000 participating organizations, CAQH has become a leading force in the healthcare industry. Its members include health plans, hospitals, medical groups, dental plans, pharmacies, and other stakeholders who are committed to improving the quality of care while reducing costs.
One of CAQH's primary objectives is to streamline provider credentialing. This process can be time-consuming and complex for both providers and payers. By using CAQH's Universal Provider Datasource (UPD), providers can submit their information once and have it shared with multiple health plans. This eliminates the need for redundant paperwork and reduces administrative costs.
Another area where CAQH provides solutions is directory maintenance. Health plan directories must be accurate so that patients can find in-network providers easily. However, maintaining these directories can be challenging due to changes in provider information or network status. With CAQH ProView®, providers can update their information in one place which then gets shared with all participating health plans.
Coordination of benefits is another area where CAQH offers solutions through its COB Smart® service. When patients have coverage from multiple sources such as Medicare or Medicaid along with private insurance, it can be difficult to determine which plan should pay first or second. COB Smart® helps identify primary coverage quickly so that claims get paid correctly without delay.
CAQH also offers other services such as electronic funds transfer (EFT) enrollment which simplifies payment processing between providers and payers; credentialing application processing which streamlines the application process for new practitioners; re-attestation services which help ensure ongoing compliance with regulatory requirements; among others.
In conclusion, if you're looking for ways to simplify your healthcare operations while improving efficiency at lower costs then look no further than CAQH Solutions! With its innovative approach towards streamlining administrative processes across various areas like provider credentialing & directory maintenance among others - this non-profit alliance has become an essential partner for many organizations within the industry today!