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CAQH 2018 Index Report Shows Welcome Increase in Automated Transactions


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The healthcare industry is making progress in automating business processes. That is the conclusion of the recently released Council for Affordable Quality Healthcare (CAQH) 2018 Index Report. 

As reported in PRNewswire.com, adoption of electronic data transmission increased as did transaction volume. Several common transactions achieved 80% electronic adoption across the sector. 

Representatives at CAQH praised the results as encouraging, noting that health plans and providers are both saving time and cutting administrative costs with more electronic transmissions. However, they acknowledged that further work is needed in order to reduce the volume of manual processing which is both expensive and time-consuming.

What Is the CAQH Index?

In addition to measuring electronic transactions between healthcare providers, the CAQH Index also tracks the adoption of HIPAA-mandated transactions. About 50% of the U.S. insured population was represented in the medical and dental plans that submitted data. The providers covered a range of specialties.

There is still substantial of room for improvement! A whopping $12.4 billion could be saved annually by the medical and dental industries if full adoption of electronic administrative transactions could be achieved. In particular, this could be achieved through greater automation by the providers.

The Index also reported a large rise in overall transaction growth is to be expected because of the growing complexity of the healthcare industry. Part of the Index report included suggestions for improvement in order to handle the volume increase and growing complexities, such as updated standards, operating rules, infrastructure and functionality.

Progress is welcome for these critical provider-health plan transactions, but there is still a long way to go.

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