What is Council for Affordable Quality Healthcare CAQH in US Healthcare?

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The Council for Affordable Quality Healthcare (CAQH) is a nonprofit alliance that was established by health insurance companies with the objective of simplifying healthcare administration. CAQH functions as a central hub where healthcare providers can submit and update all their professional information. This data is then readily accessible to participating health plans and networks, streamlining their verification process.

CAQH operates several initiatives and programs aimed at reducing administrative burdens and costs for healthcare providers, health plans, and other stakeholders enhancing the quality of data shared between stakeholders, and improving patient care.
One of its primary initiatives is the Universal Provider Data source (UPD), which serves as a centralized database for healthcare provider credentialing and re-credentialing information. The CAQH Universal Provider Data source allows healthcare providers to submit their credentialing information, such as education, training, licensure, and practice location details, in a standardized format. Health plans and credentialing organizations can then access this information electronically, streamlining the credentialing process and reducing the need for providers to submit duplicative paperwork to multiple organizations.

CAQH plays a crucial role in the US healthcare system by facilitating the exchange of information and making business processes more efficient, reduce costs, and improve payment integrity. It is a key player in the healthcare industry, providing valuable services that help to streamline operations and improve efficiency.
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