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Life Health > Long-Term Care Planning

CAQH Brings Credentialing Service To Missouri

By Staff Writer

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NU Online News Service, June 16, 2003, 11:28 a.m. EDT – The Council for Affordable Quality Healthcare, Washington, an insurance industry group, has launched its Universal Credentialing DataSource service in Missouri.

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.

CAQH is trying to tell Missouri doctors about the program by mailing them registration kits.

Participating health plans in Missouri include the local Blue Cross and Blue Shield plans; units of Aetna Inc., Hartford, and CIGNA Corp., Philadelphia; and many smaller plans.

Any health care organization with credentialing requirements can use the new credentialing service, the CAQH says. Health care organizations finance the service by paying annual administrative fees and annual fees 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, the District of Columbia, Florida, Georgia, Illinois, Iowa, Indiana, Kansas, Kentucky, Maryland, New Jersey, New York, Ohio, Oklahoma, Tennessee, Texas, Virginia and Wisconsin.

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

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