November 21, 2006
Ann Wolmer Benjamin
Director
Ohio Department of Insurance
2100 Stella Court
Columbus, Ohio 43215
Dear Director Wolmer Benjamin:
On behalf of the Healthcare Administrative Simplification Coalition (HASC) membership, we
are writing to recommend that the Ohio Department of Insurance adopt the CAQH Provider
Credentialing Application in lieu of the current Ohio Standardized Credentialing Form. Two of
your bordering states, Indiana and Kentucky, have already made this decision. HASC believes
that this recommendation will help further streamline healthcare administration in Ohio by
reducing the amount of paperwork involved in provider credentialing.
As you may know, CAQH is a nonprofit alliance of health plans, networks and trade associations
covering more than 100 million Americans. Its Universal Credentialing Datasource® (UCD) is a
uniform, electronic data-collection system that eliminates redundancy and inefficiency
commonly associated with traditional paper-based credentialing processes. UCD enables
physicians and other healthcare professionals to post the credentialing and demographic
information required by health plans, hospitals and other healthcare organizations to a secure,
national database.
The service is available to providers free of charge in all 50 states and the District of Columbia.
The centralized information is controlled by the provider, who must authorize UCD-participating
health plans and other healthcare organizations to use his or her data. Once authorized, those
health plans and other healthcare organizations can access the information for their internal
provider credentialing processes. UCD also offers them with real-time access to reliable
provider information for quality assurance and support services, such as directories and claims
processing. Regular provider updates to their record throughout the year ensures the quality and
timeliness of the UCD information. To date, more than 380,000 providers have registered to use
this system.
Before the CAQH service was available, provider practices spent countless hours and thousands
of dollars annually to complete multiple credentialing applications. Since its launch in 2002,
CAQH estimates that UCD has saved nearly $50 million and eliminated more than 1.25 million
legacy paper applications. The resulting dramatic reduction in paperwork is alleviating a
significant source of dissatisfaction and cost among the participating providers and 280 affiliated
health plans.
UCD is publicly supported by several leading health organizations, including the American
Academy of Family Physicians, American College of Physicians, the American Health
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RE: Credentialing application
Information Management Association, American Medical Association, America’s Health
Insurance Plans, the Medical Group Management Association and others.
The UCD uses the CAQH Provider Credentialing Application as its front-end in the majority of
states across the country. However, the system has been customized to conform to the Ohio
Standardized Credentialing Form for providers who log on in Ohio.
HASC believes that replacing the current Ohio Standardized Credentialing Form with the CAQH
version rather than creating a newer Ohio version will offer your state a more effective tool for
the following reasons:
• Streamlines system development: CAQH maintains a rigorous system development cycle,
which enables routine updates to the front-end application and underlying database with minimal
disruption to the provider and health plan communities. Furthermore, by deploying these
changes on a national scale, CAQH is able to avoid making numerous redundant changes to
disparate state forms.
• Ensures application is always up-to-date: CAQH has worked with health plans, providers
(AMA, AAFP, ACP, MGMA, NAMSS, etc.), accrediting bodies (NCQA, JCAHO, URAC) and
others to develop a national form that meets the needs of multiple stakeholders. CAQH routinely
reviews the form with these entities to ensure its continued compliance and relevancy. By
working with CAQH, the Ohio Department of Insurance will be able to more efficiently keep its
credentialing application current.
• Promotes a national standard: Several other states, including Indiana, Kentucky,
Tennessee, Louisiana, Vermont and the District of Columbia, have adopted CAQH’s Provider
Credentialing Application. Officials in Rhode Island are also encouraging its use from a
voluntary perspective.
• Increases portability: By promoting national uniformity, Ohio will streamline
credentialing for providers and health plans that do business in multiple states. A single national
application process increases portability for the provider and decreases complexity for the health
plan. Your state’s proximity to Indiana, Kentucky and Pennsylvania, makes this a particularly
important benefit for providers in your state.
Because our coalition is committed to reducing the administrative costs and complexity of
healthcare, we believe the efficiencies created by this initiative offer many exciting opportunities
for the State of Ohio. We are eager to arrange a follow-up discussion with you and CAQH staff
in the near future so that these and other ideas can be explored more thoroughly. In the
meantime, please visit www.caqh.org/cred/ for more information or call CAQH at (202) 861-
1492.
Best regards,
American Academy of Family Physicians
American College of Physicians
American Health Information Management Association
Council for Affordable Quality Healthcare
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November 21, 2006
RE: Credentialing application
Healthcare Billing and Management Association
Healthcare Financial Management Association
Medical Group Management Association