Health plan group offers one-time credentialing

Health plans want physicians to say goodbye to paperwork and hello to a central database.

By Damon Adams, AMNews staff. May 12, 2003.

Talk about a paper trail.

Credentialing and re-credentialing can be a paper tiger for physicians, taking hours away from patients and requiring doctors to answer the same questions on application after application after application.

The Council for Affordable Quality Healthcare, a nonprofit coalition of the nation's largest health plans and networks, is trying to ease that burden by offering the Universal Credentialing DataSource.

The Web-based system allows doctors to submit their credentials in a single application to meet the credentialing needs of health care organizations taking part in the program. The free service to doctors keeps physicians from having to submit to the cumbersome credentialing process every two to three years with individual health plans.

"The uniform application makes their lives easier right off the bat. The plans can use this without having to bother the doctor," said Sorin Davis, chair of CAQH's credentialing, marketing and communications panel.

CAQH, created in 1999 and based in Washington, D.C., launched the credentialing system in Virginia and Colorado in March 2002. So far, 19,000 doctors in those states have registered, with 7,300 completing the process, which includes providing documentation such as a U.S. Drug Enforcement Administration certificate.

The service also is offered in Washington, D.C., and 12 other states: Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Maryland, New Jersey, Ohio, New York, Tennessee and Texas. It should be expanded nationwide by the end of the year.