CAQH Offers Easy Health Plan Credentialing
The Council on Affordable Quality Healthcare (CAQH), a nonprofit alliance of health plans and trade associations working to simplify healthcare administration, has all but eliminated the need for multiple health plan credentialing applications.
CAQH has developed a national credentialing database and a universal application that is accepted by most major health plans in the state, including Aetna, United Healthcare, Cigna, and Highmark Inc. Independence Blue Cross has launched a pilot program. The Universal Credentialing DataSource® allows registered physicians and other health professionals to enter information required for credentialing into a single online application.
Although the Universal Credentialing DataSource® (UCD) is not used by all health plans, the number grows every year, and eventually, the vast majority of plans probably will participate.
Before CAQH, each health plan had its own credentialing application for physicians, creating huge administrative headaches. According to a Medical Group Management Association cost analysis, UCD has cut provider administrative costs by nearly $75 million per year.
Although, in 1998, the Pennsylvania Medical Society took a step toward consolidation by creating a standard application, it was not accepted by all the major plans.
In 2002, CAQH came out with the UCD, which was extended to Pennsylvania in 2003. As of August 2007, CAQH had more than 500,000 completed provider applications.
The service is completely free to physicians. Participating health plans pay $5,000 annually, as well as a user fee per provider application. All data is secure. Only providers and the organizations they authorize can access the database.
The State Society encourages its members to use this easy and convenient tool.
Last Updated: 10/2/2007