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8/16/2013CAQH IMPORTPRESENTER: JILLIAN LITKE, SYSTEM ANALYSTIU HEALTH C ENTRAL VERIFICATION OFFICEIU HEALTH MEDICAL STAFF2013 Morrisey Technology and Educational ConferenceABOUT INDIANA UNIVERSITY HEALTHIndiana University Health is Indiana’s ip with Indiana University School ofMedicine, one of the nation’s leading medical schools,gives patients access to innovative treatments andtherapies. IU Health is comprised of hospitals,physicians and allied services dedicated to providingpreeminent care throughout Indiana and beyond.STAFFINGTotal Physicians: 3,707Total Full-Time Team Members: 26,596Total admissions: 143,219Total outpatient visits: 2,244,320(Dec ‘11 Statistics)2013 Morrisey Technology and EducationalConference1
8/16/2013WHAT IS CAQH?The CAQH Universal Provider Datasource (UPD) is the trusted source andindustry standard for collecting provider data used in credentialing, claimsprocessing, quality assurance, emergency response, member services and more.By streamlining data collection electronically, UPD is reducing duplicativepaperwork and millions of dollars of annual administrative costs for one millionphysicians and other health professionals, as well as over 650 participating healthplans, hospitals and healthcare organizations.WHAT ARE THE BENEFITS?Benefits to the ProviderBenefits to the Organization Eliminates the need to fill out redundant,time-consuming forms. Decreased average processing turnaroundtime by 8 - 10 days Entirely free to providers, effectivelyreducing provider administrative costs bynearly 135 million per year. Reduced frequency of returned providercorrespondence due to poor address qualityby 80- 85 percent Credentialing and other updates areconveniently fulfilled online in a matter ofminutes. Near elimination (97 percent) of newproviderinitialcredentialingpacketmailings Keeps practice information current –updates are available to all approvedhospitals systems By reducing costs associated with theexchange of provider data, UPD savesmillions of dollars in annual administrativecosts across the healthcare industry. 2013 Morrisey Technology and EducationalConference2
8/16/2013HOW ARE WE USING IT?As part of the PHP, theCAQH serves as thecore of our onlineapplicationPhysicians are sent theirCAQH ID along withinstructions specific toIU Health credentialingrequirements.FILLING OUT THE CAQHPractitioners will need: CAQH ID number Practice information Practitioner ID Numbers (i.e. NPI) Copy of Curriculum Vitae Medical Licensure DEA and CDS Certificates Malpractice Facesheet Pending or settled malpractice cases 10 years of work history 3 Professional ReferencesProviders must be registered with a participating organization and have their Provider IDnumber and authentication data. The Provider ID number is included in a registration kitmailed by CAQH. Providers can then complete the following steps:Step 1:Step 2:Step 3:Step 4:Step 5:Step 6:Step 7:Activate UPD AccountComplete the ApplicationAuthorize Access to ApplicationVerify/Audit Information EnteredAttestationFax in supporting documentationReattest every 4 months to keep data up to date2013 Morrisey Technology and EducationalConference3
8/16/2013CAQH EXTRACTSDownloading an extract:Building an extract:There are two types of extracts:You can download your custom extracts through theDownload Files button, Under manage provider datawithin the DAS :You must use Safari, Firefox, or GoogleChrome to download through the DAS.Internet Explorer is not compatible.All extracts must be XML or the import will failSetting a password will causethe import into MSOW to failYou have the ability to selectthe information that is pulledinto your extractOr through the FTP site at ftp://ftpupd.caqh.org/You can obtain your username and password from yourCAQH plan administrator or if you have administrativestatus you can find them on the Edit Organization pageof the DAS.IMPORT FUNCTIONALITYTo Access the CAQH Import Screen:To import a CAQH Extract file: Extracts with passwords will fail Extracts with image files or PDFs may fail Extracts should not be unzipped Large extracts may take several minutesTo load practitioners to your work list: Select practitioners using the check box Select Accept Extract Matches2013 Morrisey Technology and EducationalConference4
8/16/2013“SCRUBBING” DATA Select data area to review An * indicates imported data A single data grid is used to comparedata between the application anddatabase (shown to the right) A dual data grid is used to match andthen compare data from the extractedpractitioner’s application to data fromthe database (shown below)Use the icon at the top left of each datagrid to post changes as you work. Whenall data areas have been reviewed, usethe larger post to database icon at the topright of the import screen to post theapplication and remove the practitionerfrom the CAQH work list.WRAP UPLessons Learned Translation TableReferencesStandard vs. Custom ExtractsPre-application StatusInstructions for providersCAQH AuditingFor more information: CAQH Universal Provider Data Source: http://www.caqh.org/overview.php Provider Quick Reference Guide: http://www.caqh.org/access-upd.php DAS Training Manual: https://upd.caqh.org/DAS/Documentation.srf2013 Morrisey Technology and EducationalConference5
8/16/2013QUESTIONS2013 Morrisey Technology and EducationalConference6
The CAQH Universal Provider Datasource (UPD) is the trusted source and industry standard for collecting provider data used in credentialing, claims processing, quality assurance, emergency response, member services and more. By streamlining data collection electronically, UPD is reducing duplicative
