News Feature | February 1, 2017

CAQH: Broader Adoption Of Electronic Business Transactions Key To Reducing Costs

Christine Kern

By Christine Kern, contributing writer

Electronic Healthcare Information Transfer

Switch could save up to $9.5 billion a year for medial health plans.

Healthcare providers could reclaim 1.1 million labor hours per week and reduce healthcare costs by $9.4 billion a year through the broader adoption of electronic business transactions according to a Council for Affordable Quality Healthcare (CAQH) report. Additionally, dental plans and providers could save as much as $1.9 billion.

New data in the 2016 CAQH Index shows conducting resource-intensive manual business transactions costs as much as $11 more per transaction, on average $6 more than when conducted electronically.

According to the study, providers currently spend an average of 8 minutes, and often up to 30 minutes, on manual tasks such as phone calls, faxes, and mailing correspondence to conduct business transactions. Prior authorization is the greatest time saver when conducted electronically, reducing the time per transaction from 20 to 6 minutes while reducing the cost from $7.60 to $1.89.

“Our organization understands the value of conducting business electronically and the greater efficiencies and cost savings realized through seamless data exchange,” says Joseph M. D’Allaird, Director of Revenue Cycle, a data contributor to the 2016 CAQH Index from Cortland Regional Medical Center. “When we can reduce the amount of paperwork for our physicians and staff, more time and resources can be spent caring for patients,”

Claims status inquiries and eligibility and benefits verification were among the electronic transactions with consistently high rates of adoption over the past three years of CAQH Index reports for medical health plans and healthcare providers, due in large part to advances in technology as well as the development of industry standards and operating rules. While use of these electronic inquiries rose by more than 5 percent, the corresponding volume of manual verifications has not declined as rapidly with participating health plans fielding more than 72 million telephone inquiries in 2015.

“Cigna is deeply committed to the efficient exchange of administrative healthcare data as a CORE-certified organization and participant in the 2016 CAQH Index, said Julie Vayer, Cigna’s vice president for Total Health & Network Operations. “By working together to standardize the way health plans process transactions, and by identifying industry best practices, we can help create a fully electronic healthcare system that will benefit consumers, providers and payers.”