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CAQH Opens Credentialing Service To Fla. Doctors

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NU Online News Service, Feb. 5, 12:02 p.m. – The Council for Affordable Quality Healthcare, Washington, an insurance industry group, is opening its Universal Credentialing DataSource service to doctors in Florida.

The CAQH developed the service in an effort to respond to doctors’ complaints about the red tape involved with qualifying for managed care provider networks. In most cases, each managed care company that includes a doctor in its network asks the doctor for the same information on paper each quarter.

The new DataSource service is supposed to help by giving doctors a tool they can use to satisfy the credentialing needs of all participating managed care organizations.

Doctors can submit information to the service, which is free for doctors, through the Web or by fax. The service will share information with a health care organization only when a doctor has given it permission to do so.

Participating health plans in Florida include units of Aetna Inc., Hartford; CIGNA Corp., Philadelphia; and Private Health Care Systems Inc., Waltham, Mass.

Any health care organization with credentialing requirements is encouraged to participate in Universal Credentialing DataSource service, the CAQH says.

Health care organizations finance the service by paying an annual administrative fee and an annual fee for each doctor checked.

Each health care organization reviews the credentialing data and decides independently whether a doctor meets its standards, the CAQH says.

The service is already available in Colorado, Connecticut, Georgia, Maryland, New Jersey, New York, Texas, Virginia and the District of Columbia.

The CAQH hopes to make the service available in all states by the end of the year.