A national healthcare organization is releasing software to automate and streamline the process by which providers submit information to health insurers to become a credentialed provider.

The application was developed by CAQH, a healthcare stakeholder organization that works with providers and payers to improve business processes.

The new product, called VeriFide, will automate almost all of the provider information-checking process for insurers—however, a few data elements are not yet available for automation, CAQH notes.

Typically, insurers are required to re-credential providers every three years. CAQH already has another product, called CAQH ProView that providers use to enter the professional information necessary for re-credentialing with insurers.

Insurers have had to verify the 14 types of provider-submitted information themselves or via a contractor, a laborious and expensive endeavor. This includes information on medical school graduated from, hospital where trained and license number, among other data.

VeriFide currently integrates with most state licensing boards, the National Technical Information Service for Drug Enforcement Agency verification, most state agencies handling controlled dangerous substance permits, the National Practitioner Data Bank, American Board of Medical Specialties, the Office of Inspector General Exclusions Database, American Board of Medical Specialties, the System for Award Management exclusion records and CAHQ ProView, with more sources expected in coming months.

Also See: CAQH effort aims to clean up insurers’ provider directories

Robin Thomashauer

VeriFide was designed to aid payers and providers, says Robin Thomashauer, executive director.

Right now, providers have different dates for submitting credentialing information to insurers, and each insurer they deal with has a different date, which is a burden to providers.

Over time, VeriFide will align re-credentialing dates so each provider has only one date for all of its payers, according to Thomashauer.

The effort will take several years, but the idea is to reduce reporting burdens and confusion for providers by having them contacted only once every three years by CAQH to have their credentialing data verified.

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