CAQH, EHNAC collaborate to lower costs for EHNs

The Council for Affordable Quality Healthcare and Electronic Healthcare Network Accreditation Commission are partnering to promote best practices and improve data exchange in Electronic Health Networks.

The hope is that with the new partnership, discounts will be offered for EHNs (also known as clearinghouses) who are seeking certification or accreditation from the CAQH Committee on Operating Rules for Information Exchange (CORE) and the EHNAC Healthcare Network Accreditation Program (HNAP).

“Both of our organizations are committed to improving healthcare data exchange,” said Robin Thomashauer, CAQH's executive director. “By working together, we can more quickly advance adoption of industry best practices.”

CAQH's CORE initiative is designed in a series of phases to first create a set of operating rules that  allow providers to securely obtain eligibility and benefits information. These phases extend to include a set of operating rules on the claims status transaction, enabling providers to have access to claims status electronically in an effort to reduce to amount of manual intervention.

As a first joint action, clearinghouses that achieve CORE certification will be eligible for a reduced fee in applying for HNAP accreditation, and vice versa.

“Our partnership is a logical extension of the work both of us do to broaden the use of electronic healthcare transactions and eliminate administrative redundancy,” said Lee Barrett, EHNAC's executive director. “We are delighted to collaborate with CAQH on streamlining healthcare administration.”

HNAP, the main accreditation program created by EHNAC, has created a set of standards for privacy, confidentiality measures, level-of-service and escalation procedures, transaction response time and systems availability. HNAP also assesses certain security infrastructure and data integrity measures.

Both programs from CAQH and EHNAC will be reviewed for participation requirements and evaluation methods to ensure that overlaps are avoided. CAQH and EHNAC officials say they hope the reviews will make it easier for both organizations to collaborate on new actions advancing the overall goal of a more efficient data exchange system.