The Council for Affordable Quality Healthcare (CAQH) is a non-profit alliance of health plans and trade associations, developing and leading initiatives that positively impact the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients and health plans.
CAQH realizes that the availability and sharing of electronic data is driving a revolution in our nation’s healthcare system, and access to accurate, timely provider data is critical for its success. Without timely access to provider data, today’s healthcare organizations will suffer.
There are many cost implications associated with poor provider data management. Two areas where limited access to accurate, timely provider data are driving up costs are credentialing and directory maintenance.
Credentialing is the process of obtaining, verifying, and assessing the qualifications of a practitioner/provider to provide care or services in or for a healthcare organization. CAQH research indicates that many organizations use multiple methods for credentialing and that moving to a single credentialing platform could reduce annual credentialing costs by 40%. On a national level, CAQH estimates that streamlining the exchange of credentialing information on one platform could save as much as $2.26 billion annually.
Provider data collection requirements are becoming increasingly more complex and require updating and confirming with greater frequency. To improve accuracy, regulators have set minimum requirements for how frequently plans must contact practices to verify and update their information.
CAQH estimates providers incur annual cost of $2.65B to maintain directory records.
There's a lot of overlap between the data sets required for credentialing and directory maintenance. That is why streamlining provider data collection is critical to healthcare organizations’ success. According to CAQH and VerityStream shared best practices, your credentialing software should:
Provider Directory Management is often a highly manual process that creates numerous opportunities for human error. Your directory should connect to your credentialing solution to:
A 2019 AMA survey found that 67% of physicians are interested in one interface to update payers. Providers want to spend more times with patients and less time on paperwork. With a Standardized Data Collection process in place they can:
Managing provider data has major financial implications on your organization. If you’re looking to seamlessly standardize the process, VerityStream can help. We currently serve over 2,400 hospitals and 1,300 outpatient facilities in the U.S.