Experience fast turnaround and high quality provider data verification… · 2017-03-28 · the...
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Provider credentialing just got easier. Reduce the cost and improve the quality and speed of the provider data verification process with an industry-wide solution. CAQH collaborated with health plans to develop an industry-wide solution that authenticates the accuracy and completeness of healthcare provider information to support credentialing decisions, while reducing the burden for both plans and providers. VeriFide™, a CAQH Solution®, improves the speed, integrity, and quality of the credentialing verification process — eliminating overlapping, non-differentiating business processes. Over time, VeriFide will move the industry towards a single credentialing date for each provider, resulting in even lower costs. The VeriFide Difference Seamless integration with CAQH ProView® VeriFide integrates seamlessly with CAQH ProView, the CAQH Solution regularly accessed by over 1.4 million providers to self-report and attest to their professional and practice information. This success- ful record of working with providers to supply their data means that CAQH consistently receives a high response rate in provider outreach efforts. Automation with most primary data sources The VeriFide solution deploys advanced automated technologies to compare each provider’s information against primary data sources for accuracy. By eliminating manual processes whenever possible, the solution reduces the time required to work on a provider file, as well as the likelihood of human error. Experienced CAQH staff assist with files requiring additional follow-up. Experience fast turnaround and high quality provider data verification. VeriFide returns 98% of initial files within 14 days, with 98.5% accuracy and completeness. Standardized data elements As an NCQA-certified Credentials Verification Organization (CVO), CAQH leverages the industry- wide standard set of data elements to verify the 14 key elements that are deemed essential for the credentialing process.
Transcript of Experience fast turnaround and high quality provider data verification… · 2017-03-28 · the...
Provider credentialing just got easier. Reduce
the cost and improve the quality and speed of
the provider data verification process with an
industry-wide solution.
CAQH collaborated with health plans to develop an industry-wide solution that authenticates the accuracy and completeness of healthcare provider information to support credentialing decisions, while reducing the burden for both plans and providers.
VeriFide™, a CAQH Solution®, improves the speed, integrity, and quality of the credentialing verification process — eliminating overlapping, non-differentiating business processes. Over time, VeriFide will move the industry towards a single credentialing date for each provider, resulting in even lower costs.
The VeriFide Difference
Seamless integration with CAQH ProView®VeriFide integrates seamlessly with CAQH ProView, the CAQH Solution regularly accessed by over 1.4 million providers to self-report and attest to their professional and practice information. This success-ful record of working with providers to supply their data means that CAQH consistently receives a high response rate in provider outreach efforts.
Automation with most primary data sourcesThe VeriFide solution deploys advanced automated technologies to compare each provider’s information
against primary data sources for accuracy. By eliminating manual processes whenever possible, the solution reduces the time required to work on a provider file, as well as the likelihood of human error. Experienced CAQH staff assist with files requiring additional follow-up.
Experience fast turnaround and high quality provider data verification. VeriFide returns 98% of initial files within 14 days, with 98.5% accuracy and completeness.
Standardized data elementsAs an NCQA-certified Credentials Verification Organization (CVO), CAQH leverages the industry- wide standard set of data elements to verify the 14 key elements that are deemed essential for the credentialing process.
CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH
accelerates the transformation of business processes, delivering value to providers, patients and health plans. Visit www.caqh.org to learn more.
Industry-wide alignment of provider credentialing datesNCQA requires health plans to re-credential providers at least once every three years. For providers con-tracting with multiple health plans, this process occurs repeatedly over each three-year period. To reduce this duplication in the credentialing process, over time VeriFide will align credentialing dates for providers across the industry.
Categorized results for quicker credentialingEach verified data element in the provider file is categorized by VeriFide, based on the results of the verification; for example, A is valid and current, B is potentially irregular and C is very irregular. This enables each health plan to immediately and auto-matically route the files needing special follow-up to their appropriate departments, reducing delays.
VeriFide Benefits
Health plans benefit from:
• Lowered costs from economies of scale achieved by aligning the timing of provider credentialing events across organizations.
• Increased file accuracy and completeness (98.5%) from greater automation, diligent CAQH follow-up and improved provider response to queries.
• A reduced credentialing cycle, returning 98% of the initial files within 14-days, and 100% of re-credential files 60 days before the provider’s target date.
• Bundled pricing with CAQH ProView that includes all pass-through data charges.
Providers and Practice Managers benefit from:
• Reduced time from initial credentialing to network participation and payment.
• Improved satisfaction and less administrative burden through coordinated outreach on behalf of multiple health plans.
• Less confusion because required credentialing information is consistent across plans.
• Dynamic updates to all participating health plans designated by the provider.
Learn More
Join the growing list of health plans using VeriFide. Contact a member of our Business Development team by emai l ing [email protected] or v is i t www.caqhverifide.org to learn more.
