CAQH
CAQH provides data solutions, operating rules, and research to enhance efficiency and interoperability in the healthcare industry, serving nearly 1,000 health plans, 2 million providers, and government entities.
CAQH Services
CAQH provides a range of services designed to streamline healthcare business processes and improve efficiency. These include data solutions, consulting services, and custom data solutions addressing specific healthcare business challenges. Nearly 1,000 health plans and 2 million providers utilize CAQH's services to connect, exchange information, and operate more effectively. CAQH also offers interactive webinars and events to promote awareness and adoption of healthcare operating rules.
CAQH CORE
CAQH CORE is an initiative by CAQH that brings the healthcare industry together to enhance interoperability and automation while aligning administrative and clinical activities. Designated by the Secretary of the Department of Health and Human Services (HHS) as the National Operating Rule Authoring Entity for HIPAA-covered administrative transactions, CAQH CORE develops operating rules through a collaborative and transparent process. These rules support various standards to make electronic data transactions predictable and consistent and include areas such as eligibility, claim status, and prior authorization.
CAQH Provider Data Solutions
CAQH Solutions offer various provider data solutions such as credentialing suite, primary source verification, sanctions monitoring, and directory management. These solutions help connect healthcare plans and providers, ensuring accurate and up-to-date information on healthcare professionals. This streamlining of provider data management helps reduce costs, improve payment integrity, and transform business processes across the healthcare industry.
CAQH Member Data Solutions
CAQH Member Data Solutions focus on improving the coordination of benefits and offering Medicaid solutions. These solutions are designed to mitigate errors, streamline processes, and ensure the integrity of member data across health plans. By providing reliable and accurate member data, CAQH enables healthcare organizations to operate more efficiently and effectively.
CAQH Insights and Index Report
CAQH Insights identifies opportunities to enhance and streamline healthcare processes and measures the impact of automation on the industry. The CAQH Index Report serves as the authoritative resource on the progress towards automated and efficient business processes within healthcare. This comprehensive analysis helps healthcare organizations understand trends, benchmark their performance, and identify areas for improvement.