HealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsDeliver custom or industry designed product training directly to patient and resident care environments to reinforce proper use.
View All ProductsTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsHealthStream's EMS Program offers a comprehensive, CAPCE accredited EMS course library that meets National Registry annual recertification.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsExperience standardized and centralized healthcare credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsFinally, a comprehensive resource to support collecting, storing, and sharing credentialing data with ease.
View All ProductsHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All ProductsMitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.
Learn MoreAccording to The Hill, “The country’s health care tab came in at a whopping $3.3 trillion in 2016 — 17.9 percent of GDP. We spend $10,348 per person, per year, nearly twice the average of other modern economies. Yet despite the fortune spent, we still don’t have better health outcomes.”
While the politicians debate the expenses and who should pay the tab, the healthcare industry is taking action with the goal of reducing healthcare costs. One such effort is being driven by the Council for Affordable Quality Healthcare (CAQH), a non-profit alliance of health plans and related associations that has banded together around the shared goal of streamlining the business of healthcare.
1. According to the CAQH, “The ongoing need to reduce healthcare costs— especially administrative expenses—while concurrently increasing information accuracy is at the heart of CAQH activities. In concert with a wide range of healthcare stakeholders, CAQH develops and implements shared, industry-wide initiatives to eliminate long-term business inefficiencies, producing meaningful, concrete benefits for healthcare providers, health plans and patients.” CAQH projects that their initiatives will fundamentally change the direction of healthcare and redefine how the industry does business.
2. CAQH believes that provider data drives the most fundamental processes in the healthcare system, and understands that although the industry spends more than $2 billion annually* to maintain provider data, inaccuracies and inefficiencies are still pervasive. In the Industry Roadmap for Provider Data, CAQH identifies several key issues that contribute to the persistence of provider data inaccuracies. These include:
...although the industry spends more than $2 billion annually* to maintain provider data, inaccuracies and inefficiencies are still pervasive.
3. Based on its analysis of provider data issues plaguing the industry, CAQH convened the Provider Data Action Alliance (Alliance), a cross-industry group of leaders representing health plans, hospitals and health systems, government, regulators and health information exchanges, to develop the Industry Roadmap for Provider Data. The Roadmap presents a “collaborative approach for finally addressing the provider data challenge through industry alignment on a core set of principles, a vision for a healthy provider data ecosystem and recommendations for key steps forward.”
The core principles identified to guide the development of an industry solution state:
The vision for a healthy provider data ecosystem centers on four critical components:
4. CAQH’s vision for a centralized authoritative solution is coming to fruition with the development of solutions that authenticate the accuracy and completeness of provider information to support credentialing decisions. One such solution is CAQH ProView®. A solution described by CAQH as: “A web-based solution used by more than 1.4 million providers to self-report and share a wide range of demographic and professional information with more than 900 participating health plans, hospitals, health systems and provider groups. This data is then used for credentialing, network directories, claims administration and more.”
5. At this point in time, participation in CAQH initiatives, including CAQH ProView is voluntary. But some health plans and other healthcare organizations are beginning to request that their network providers use CAQH ProView for new recredentialing events. We expect this trend to grow, and when it does, your medical group practice needs to be ready.
Preparing for CAQH Enrollment
Because provider data is involved in so many processes, the core set of “fundamental” provider data elements that you need to collect for CAQH Enrollment is vast. A sample of the information needed to begin CAQH Enrollment is listed in the ProView Provider Quick Reference Guide and includes:
Many of the medical group practices we work with believe that all this required data is somewhere, but that somewhere is usually not ‘right at their fingertips’. Just over half of the provider enrollment professionals we surveyed use some type of software solution to help automate their enrollment processes. The rest continue to manage enrollment by keeping data in paper files, Excel spreadsheets, and Access or homegrown databases. If you don’t have a single source of truth to collate and track your provider data, you’ll struggle with CAQH integration.
Putting technology to work for you is the key to successful CAQH integration. Solutions like Enroll can greatly simplify the enrollment process. Enroll offers an easy approach to collecting accurate information on behalf of your providers and sharing it with CAQH and every health plan that needs access to it. With Enroll you can dramatically accelerate the provider enrollment process, shrink enrollment timelines (by 65 percent or more), slash costs (by 50 percent or more), and reduce aging receivables (by as much as 97 percent)
Technology is the Key to CAQH Integration
For successful CAQH integration, seek a solution that checks the following boxes:
Features a comprehensive database of U.S. physicians, nurse practitioners, physician assistants, allied health professionals, and registered nurses that includes data elements like demographics, addresses, specialties, licenses, affiliations, education, and expertise details and is constantly updated.
Enables intuitive provider enrollment with functionality that allows providers to auto populate required forms with real-time validated data from sources like AMA and CAQH.
Features a large content database of thousands of pieces of instantly deployable content to help you manage all of your processes including; workflows for initial and recredentialing, expirables management, surveys, API, HL7 imports/exports, dashboards, and online applications.
Has the most up-to-date, standardized industry data tables that put all the data you need within easy reach including data from: payers, hospitals, malpractice, insurance, taxonomy, Universities, States, DEA schedules, zip codes, FOL, diagnosis, and ICD10 codes.
Offers a one-stop shop for providers and reviewers to share data.
If you’re struggling with CAQH integration, VerityStream can help you get your own house in order. Ultimately, a consistent process for collecting provider data will improve your data quality, fill in missing gaps, and benefit your organization and the healthcare industry as a whole. Request a free CAQH check-up with a VerityStream representative today.
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ResuscitationIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsHealthStream's EMS Program offers a comprehensive, CAPCE accredited EMS course library that meets National Registry annual recertification.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsLearn more about HealthStream's Provider Credentialing, privileging, & enrollment solutions.
View All CredentialingExperience standardized and centralized healthcare credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All Products