CAQH CORE & NACHA Joint National Webinar - September 10

CAQH CORE & NACHA Joint National Webinar with  Midwest Center for Women's Healthcare and Hospital Corporation of America, Inc. THURSDAY, SEPTEMBER 10, 2015  2:00 - 3:00 PM ET REGISTER NOW There is no fee to attend. The Benefits of Going Paperless in Your EFT/ERA Transactions for Small & Rural Hospitals - A Multi-Provider Practice & a Large Hospital Group Share Their Experiences Come join our partners from NACHA - The Electronic Payments Association - as we talk about the benefits of going paperless in your healthcare financial transactions. CAQH CORE will describe how federally-mandated Operating Rules require health plans to support a provider's ability to streamline their payment posting. NACHA will give an overview of the ACH Network and the 2015 Healthcare Electronic Funds Transfer (EFT) Volumes, as well as the Healthcare EFT Standard which leads to proven efficiencies and savings. We will also have two case studies on the time-saving benefits of switching from paper checks and explanation of benefits to the healthcare EFT and Electronic Remittance Advice (ERA). The case studies will feature the experiences of finance/billing professionals from both a mid-sized provider and a large hospital group. Our case study speakers will be Eric Brodsky, Director of Billing and Operations of the Midwest Center for Women's HealthCare in the suburban Chicago area, as well as Doug Downey, Vice President, Treasury Services, HCA, Inc. in Nashville, TN. Who Should Attend? This webinar is designed for all health care entities that can benefit from use of electronic transactions: hospitals, providers, health plans, vendors and clearinghouses. Departments that would find it useful include: Finance/Billing, Compliance, IT Claim Operations and Process Improvement. If you have questions, please contact CORE@caqh.org. About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

CAQH Catalyst Newsletter - August 2015

August 2015

Rebranding and Website Launch CAQH has launched a redesigned website developed to communicate more effectively and improve the visitor experience. In addition to featuring refreshed branding that represents the mission and vision of the organization, www.CAQH.org now has a new structure that makes information easier to find. As the scope of CAQH activities expands beyond simplifying administrative processes to focus more broadly on "streamlining the business of healthcare", the redesigned website more comprehensively profiles the work of the organization. Continue reading...

The Value & Impact of Collaboration:  CAQH Presentation at AHIP Institute 2015  "Collaborating to Take Costs Out of the Business of Healthcare" Collaborative projects are advancing operational efficiencies, improving health plan and provider relations and reducing millions in costs for the healthcare system at large, according to examples recently provided by senior executives from three national health plans at AHIP Institute 2015. The presentation by CAQH explored the advantages of using industry-wide collaboration to improve routine business processes. In the session, titled "Collaborating to Take Costs Out of the Business of Healthcare," panelists explained how this approach helps ease the burden on individual health plans and provider organizations, while reducing unnecessary administrative costs. Continue reading...

CAQH CORE Testifies Before HHS Review Committee on Benefits/Challenges of Operating Rules At the inaugural hearing of the Affordable Care Act (ACA)-mandated Review Committee in June, CAQH CORE presented compelling testimony that operating rules have resulted in significant contributions to the business needs of the healthcare industry. CAQH CORE also emphasized that many opportunities still exist to use operating rules to achieve interoperable data exchange. Continue reading...

Other News

New CAQH Staff CAQH has welcomed the following new staff in 2015: Abrielle Anderson Counsel Erin Gibson Major Account Manager Jyoti "JJ" Jalali Senior Manager, Business Development Carl Johnson, Jr. Major Account Manager Sarah Kana Communications Associate Jessica Porras CAQH CORE Senior Manager for Education and Outreach Jack Unverferth Director of Technology Drew Voytal CAQH CORE Senior Project Associate for Education and Outreach   Continue reading...

CAQH CORE & NACHA JOINT NATIONAL WEBINAR Thursday, September 10, 2015 | 2:00 - 3:00 PM ET Join CAQH CORE and NACHA, along with Midwest Center for Women's Healthcare and Hospital Corporation of America, Inc., for a national webinar: "The Benefits of Going Paperless in Your EFT/ERA Transactions for Small & Rural Hospitals - A Multi-Provider Practice & a Large Hospital Group Share Their Experiences". Register or Learn More

CAQH In the News AHA Advisory Group Issues Report on Interoperability  Technology to Streamline Physician Credentialing 26 Recipients of Becker's Healthcare 2015 Leadership Awards  Orbograph Releases White Paper, "Strategic Considerations For Paper-based Healthcare Payments" AHIP: Payers team up to reduce administrative waste At AHIP Institute, collaboration is the name of the game Payer perspective: 7 key points on healthcare payments Cut costs, boost efficiency with the healthcare EFT standard

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National Webinar: EFT/ERA CAQH CORE Certification - Is it right for your organization?

Voluntary EFT/ERA CAQH CORE Certification National Webinar with MaineCare and PNC Healthcare TUESDAY, AUGUST 11, 2015  2:00 - 3:00 PM ET REGISTER NOW There is no fee to attend. "Is EFT/ERA CAQH CORE Certification right for your type of organization?" Why should a State Medicaid Agency become CAQH CORE-certified? Why would a clearinghouse seek CAQH CORE Certification? The fact is that CAQH CORE Certification benefits a multitude of stakeholder types. Join us on August 11th to learn more and get an insider look at the experiences of these recent CORE-certified entities. And get helpful tips from CAQH CORE-authorized Testing Vendor EDIFECS who will perform a live demo of their test site. What will you learn? Experience of MaineCare and PNC Healthcare in completing their recent CAQH CORE Certification process, including their best practices and lessons learned, and resulting benefits to their EFT/ERA transaction systems. How to navigate the complexities of trading partner coordination and trading partner role identification for maximum testing and certification success. What interfacing with the live CAQH CORE-authorized testing site means and tips ensuring that the CAQH CORE Certification testing process goes smoothly. Who Should Attend? All entities interested in voluntary CAQH CORE Certification are welcome to attend this educational webinar, especially those interested in EFT/ERA. If you have questions, please contact CORE@caqh.org. About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

TOMORROW: CAQH CORE National Webinar on Uniform Use of CARCs & RARCs - How to Improve Your Revenue Cycle Management

CAQH CORE NATIONAL WEBINAR TOMORROW THURSDAY, JULY 16, 2015   3:00 - 4:00 PM ET REGISTER NOW There is no fee to attend. Uniform Use of CARCs and RARCs Maintenance Update:  How to Improve Your Revenue Cycle Management Join us on July 16th to learn how the CAQH CORE 360: Uniform Use of CARCs and RARCs Rule is providing uniformity in the use of claim payment adjustment/denial codes and offering significant benefits for all industry entities. Hear from a Co-chair from the CAQH CORE Task Group charged with maintaining the CORE Code Combinations about recent Task Group efforts to apply industry-driven adjustments to the code combinations, and how to get involved in the evolution of the CAQH CORE 360 Rule and the CORE Code Combinations. Also, get an insider look from United Healthcare as they share their experience using the codes, including benefits and lessons learned. What will you learn? Background and requirements of the Uniform Use of CARCs and RARCs Rule and orientation to the CAQH CORE Code Combination Maintenance Process. Results of the Task Group's recently completed maintenance reviews to ensure compliance with the standard code lists and address industry feedback. The role of the CORE Code Combinations Task Group with a real-world implementer perspective from United Healthcare on the value of this work flow change. Who Should Attend All entities are welcome to attend this educational webinar. If you have questions, please contact CORE@caqh.org.   About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

RFI - Health Plan Identifier: Action Model Letter Development

Good afternoon, The U.S. Department of Health and Human Services (HHS) is seeking comments on a Request for Information (RFI) on the Health Plan Identifier (HPID). The comments are due to HHS by July 28th, 2015. The RFI asks for comments  on the following three issues regarding the HPID: The HPID enumeration structure outlined in the HPID final rule, including the use of the CHP/SHP and OEID concepts ["HPID Enumeration Requirements"]. The use of the HPID in HIPAA transactions in conjunction with the Payer ID["HPID Use Requirements"]. Whether changes to the nation's health care system, since the issuance of the HPID final rule published September 5, 2012, have altered your perspectives about the function of the HPID. CAQH CORE will develop a model letter which entities can use at their discretion. CAQH CORE will take several steps, as it has in the past when HHS regulatory action called for public comments, to produce this model letter. Those steps are as follows: Activity Date of Event Open CAQH CORE call regarding key themes and questions  July 1, 2015 Complete CAQH CORE Participant call to discuss Draft Model Letter (Registration for call available HERE; Draft letter will be posted prior to call on CAQH CORE website. Should you have a position or draft letter you would like to share, please send toCORE@caqh.org by July 14th) July 15, 2015 3 - 4 pm ET Final Model Comment Letter (Final model letter will be posted on CAQH CORE website and sent via email. The CAQH CORE Board will be submitting a final CAQH CORE letter by July 28th.) July 21, 2015 Please join CAQH CORE to share your input on this important effort. For any questions, please reach out to the CAQH CORE staff at CORE@caqh.org. Thank you, CAQH CORE Staff

July 16th CAQH CORE National Webinar on Uniform Use of CARCs & RARCs - How to Improve Your Revenue Cycle Management

CAQH CORE NATIONAL WEBINAR THURSDAY, JULY 16, 2015   3:00 - 4:00 PM ET REGISTER NOW There is no fee to attend. Uniform Use of CARCs and RARCs Maintenance Update:  How to Improve Your Revenue Cycle Management Join us on July 16th to learn how the CAQH CORE 360: Uniform Use of CARCs and RARCs Rule is providing uniformity in the use of claim payment adjustment/denial codes and offering significant benefits for all industry entities. Hear from a Co-chair from the CAQH CORE Task Group charged with maintaining the CORE Code Combinations about recent Task Group efforts to apply industry-driven adjustments to the code combinations, and how to get involved in the evolution of the CAQH CORE 360 Rule and the CORE Code Combinations. Also, get an insider look from United Healthcare as they share their experience using the codes, including benefits and lessons learned. What will you learn? Background and requirements of the Uniform Use of CARCs and RARCs Rule and orientation to the CAQH CORE Code Combination Maintenance Process. Results of the Task Group's recently completed maintenance reviews to ensure compliance with the standard code lists and address industry feedback. The role of the CORE Code Combinations Task Group with a real-world implementer perspective from United Healthcare on the value of this work flow change. Who Should Attend All entities are welcome to attend this educational webinar. If you have questions, please contact CORE@caqh.org.   About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

TOMORROW: RFI - Health Plan Identifier: Action Model Letter Development

Good afternoon, The U.S. Department of Health and Human Services (HHS) is seeking comments on a Request for Information (RFI) on the Health Plan Identifier (HPID). The comments are due to HHS by July 28th, 2015. The RFI asks for comments  on the following three issues regarding the HPID: The HPID enumeration structure outlined in the HPID final rule, including the use of the CHP/SHP and OEID concepts ["HPID Enumeration Requirements"]. The use of the HPID in HIPAA transactions in conjunction with the Payer ID["HPID Use Requirements"]. Whether changes to the nation's health care system, since the issuance of the HPID final rule published September 5, 2012, have altered your perspectives about the function of the HPID. CAQH CORE will develop a model letter which entities can use at their discretion. CAQH CORE will take several steps, as it has in the past when HHS regulatory action called for public comments, to produce this model letter. Those steps are as follows: Activity Date of Event Open CAQH CORE call regarding key themes and questions (Registration for open call available HERE; potential themes and questions to be posted on CAQH CORE website. Should you have a position you would like to share, please send tocore@caqh.org by June 30th)  July 1, 2015 3 - 4 pm ET CAQH CORE Participant call to discuss Draft Model Letter (Registration for call available HERE; Draft letter will be posted prior to call on CAQH CORE website. Should you have a position or draft letter you would like to share, please send tocore@caqh.org by July 14th) July 15, 2015 3 - 4 pm ET Final Model Comment Letter (Final model letter will be posted on CAQH CORE website and sent via email. The CAQH CORE Board will be submitting a final CAQH CORE letter by July 28th.) July 21, 2015 Please join CAQH CORE to share your input on this important effort. For any questions, please reach out to the CAQH CORE staff at CORE@caqh.org. Thank you, CAQH CORE Staff