The Council for Affordable Quality Healthcare (CAQH) is now recruiting healthcare providers and health plans to participate in their 2016 index. CAQH is a non-profit organization of health plans and other industry groups dedicated to improve the healthcare industry. The organization has been granted authority by the federal government to establish standard operating rules for all the business transactions that take place in the healthcare sector.
The CAQH index tracks and reports the progress made by healthcare industry in its transition from manual to the electronic transactions. This index also estimates the savings to healthcare system with increased use of electronic transactions. This index estimates the proportion of common administrative transactions that are conducted electronically all over the industry. This includes both healthcare professionals and health plans.
The CAQH index for 2015 collected and analyzed more than four billion transactions from varied healthcare plans. It offered reference data that helped organizations to know the fields in which they excel and the areas that have scopes for improvement. The transaction included:
- Eligibility and benefit verification
- Referral certification
- Claim submission
- Claim payment
- Coordination of benefits (COB) claims
- Remittance advice
- Prior authorization
- Claim status inquiry
The CAQH index specifically measure adoption rates, costs and the savings that are associated with the shift from manual to electronic mediums. Reports say that there have been steady increases in adoption of HIPAA transactions and the recently released CAQH index for 2015 proves that the healthcare systems could still have more than eight billion dollars each year. This is by replacing the manual transactions with electronic HIPAA transactions.
The CAQH index is solely based on data that is submitted by commercial health plans and healthcare providers in the US. The commercial health plans represented more than 118 million covered people, which is almost half of the commercially insured people in the US.