Web-based physician credentialing system seen as time-saver

Yet some doctors said the service is still too complicated, and they are not sure which health plans participate in it.

By Damon Adams, AMNews staff. Aug. 2, 2004.

Maryland internist Howard Lanham, MD, has plenty to deal with: lower reimbursements, rising liability insurance rates and the rigors of running a solo practice. He doesn't have time to fuss with a lot of paperwork.

Getting credentialed with health care organizations used to require filling in stacks of applications -- one application per health plan -- and copying licenses and certificates to accompany each form. "If you're talking about 30 pages per 12 health plans, that's a lot of time," said office manager Marty Lanham.

Dr. Lanham has found an easier way. He now uses the Universal Credentialing DataSource, a Web-based system that allows Dr. Lanham and other physicians to submit their credentials in a single application to meet the credentialing requirements of participating health plans.

"Anything we can do to be more efficient, we want to do," said Dr. Lanham, who practices in Westminster, Md.

The credentialing system was launched in March 2002 in Colorado and Virginia by the Council for Affordable Quality Healthcare, a nonprofit coalition of the nation's largest health plans and networks. Today, the service is used in 49 states (Nevada is expected to be included by the end of the year), and 40 health plans are participating, including Aetna, CIGNA and UnitedHealthcare.

More than 100,000 physicians have registered, eliminating their task of completing multiple applications for credentialing and recredentialing.

"There's no more putting an application in the mail," said Sorin Davis, chair of CAQH's credentialing, marketing and communications group.