CAQH: National Effort to Simplify the Credentialing Process for Physicians Launches in New Jersey.

Business Editors/Health/Medical Writers

WASHINGTON--(BUSINESS WIRE)--Feb. 19, 2003

- To ease credentialing for New Jersey physicians, the Council for Affordable Quality Healthcare (CAQH), today announced the launch of its Universal Credentialing DataSource system in the state.

CAQH, a not-for-profit alliance of the nation's leading health plans and networks, developed this system to help physicians more easily and cost-effectively provide required credentialing information to health care organizations. Participating health plans in New Jersey include Horizon Blue Cross Blue Shield of New Jersey, WellChoice HMO of New Jersey, Oxford, Aetna, CIGNA HealthCare of New Jersey, Great-West/One Health Plan, Health Net and Private Healthcare Systems.

The new CAQH Universal Credentialing DataSource service enables physicians to satisfy the credentialing needs of all participating health care organizations by submitting their credentials one time to the uniform system. Information can be updated anytime through the convenience of the Web or by fax. The free, secure service makes it possible for physicians and their office staffs to spend just a few minutes each quarter to confirm that their credentialing information is complete and accurate.

Today, physicians face the redundant and time-consuming process of credentialing or re-credentialing with individual health plans once every three years. During this timeframe, information often becomes outdated. The CAQH system provides a time-saving solution that helps ensure information is up-to-date for credentialing and payment processing, and for use in health plans' electronic and paper directories.

"Today, physicians are tasked with a number of administrative responsibilities that can take them away from valuable time with patients," said William J. Marino, president and CEO of Horizon Blue Cross Blue Shield of New Jersey. "CAQH members have joined together to find out from physicians how we can help make the business of health care easier. Now, New Jersey physicians have access to a free, universal tool that will make the credentialing process faster and more effective."

Any health care organization with credentialing requirements is encouraged to participate in Universal Credentialing DataSource. All participating health care organizations pay an annual per physician/provider fee for unlimited access to completed records, in addition to a small annual administrative fee to offset system maintenance and customer service requirements. Each health care organization reviews and verifies credentialing data, and decides independently whether or not a physician meets its standards for participation.

Data collected through Universal Credentialing DataSource is maintained by CAQH in a secure, state-of-the-art datacenter, and is only made available to health care organizations that have been authorized by each physician. Health care organizations are automatically notified when a physician's information changes.

"The Universal Credentialing DataSource system will lessen the time that physicians and their staffs spend on what has been a long and tedious process, " said Jeff Folick, executive vice president of regional health plans and specialty companies at Health Net. "The members of CAQH have worked closely with physicians in New Jersey and other states to make simpler credentialing a reality."

To create Universal Credentialing DataSource, CAQH worked with providers, health plans and networks, professional associations, insurance regulators and accreditation associations. The service first launched in Virginia and Colorado in March 2002, and it is now also available to physicians in Connecticut, Florida, Georgia, Maryland, New York, Texas and Washington, D.C. CAQH plans to launch Universal Credentialing DataSource nationwide in 2003.

To raise awareness of the availability of Universal Credentialing DataSource in New Jersey, CAQH has mailed a registration kit to physicians in the state, inviting them to participate in the service. The kit includes a temporary ID that physicians can use to register in the system. Physicians who are affiliated with a participating health plan, but who have not received the registration kit, can call the Help Desk at 888-599-1771, or refer to the CAQH Web site at www.caqh.org for more information.

About CAQH

CAQH, the Council for Affordable Quality Healthcare is a not-for-profit alliance of America's leading health plans and networks, committed to improving the quality of health care and reducing administrative burdens for physicians, patients and payers. Created in 1999, CAQH member organizations today provide and administer health care coverage for more than 100 million Americans.

CAQH members include: Aetna, American Association of Health Plans, Anthem Blue Cross and Blue Shield, AultCare, Beech Street Corporation, Blue Cross and Blue Shield Association, Blue Cross and Blue Shield of North

Carolina, CareFirst BlueCross BlueShield, CIGNA, Empire Blue Cross and Blue Shield, FirstHealth, Great-West, Group Health Cooperative, Health Insurance Association of America, Health Net, HealthPartners, Highmark Blue Cross Blue Shield, Horizon Blue Cross Blue Shield of New Jersey, Independence Blue Cross, MultiPlan, Mutual of Omaha, Oxford Health Plans, PacifiCare, Private Healthcare Systems, The Regence Group, and WellPoint.