This month, April Todd, Senior Vice President CORE and Explorations, was invited to speak about prior authorizations on the Change Healthcare.

CAQH has announced the development of a centralized directory of validated payer FHIR endpoints and third-party applications. This solution will simplify how healthcare organizations and app developers connect with each other to help consumers access and transfer their healthcare information.

The National Association of Insurance Commissioners (NAIC)’s Center for Insurance Policy and Research (CIPR) has released the final installment of its comprehensive study, “Rising Health Care Costs: Drivers, Challenges and Solutions.” A compilation of individually authored papers, this report brings together healthcare thought leaders, researchers and practit

In August, CAQH CORE hosted a webinar to share initial findings of the Prior Authorization Pilot & Measurement Initiative, which works with industry organizations to measure the impact of standards and operating rules on efficiency metrics and staff experience. The case study webinar with Cleveland Clinic and PriorAuthNow, the first in a series, highlighted the impact that prior authorization (PA) automation and workflow integration may have on the health system.

To mark the 20th anniversary of CAQH, this year’s annual report tells the story of the organization’s founding, provides highlights from initiatives over the years, and outlines its vision to transform the business of healthcare in the future. Click here to read the 2019 CAQH annual report.

Health insurers use prior authorization as a check on the safety, quality, necessity and cost of medical services. When done manually, this process can be confusing, labor-intensive and expensive for the provider and payer teams that manage it. This can create delays to patient care, and frustrations across the industry.

CAQH has earned certifications for information security by the Health Information Trust (HITRUST) Alliance for CAQH ProView®, COB Smart®, EnrollHub

CAQH has announced its support for a resolution passed by the National Lieutenant Governor’s Association (NLGA) recognizing the need for administrative simplification in our nation’s healthcare system.