New York State Adopts Universal Provider Datasource to Reduce Administrative Costs for Medicaid

America's Second Largest Medicaid System Streamlines Provider Data Collection and Enrollment

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Mar 04, 2010, 11:45 ET

WASHINGTON, March 4 /PRNewswire/ -- CAQH® announced today that the New York State Department of Health, Office of Health Insurance Programs (New York Medicaid) has chosen the Universal Provider Datasource® (UPD) to electronically collect standardized provider data for participants in the state Medicaid program. The second largest program of its kind in the United States, New York Medicaid covers approximately 4.3 million residents.

Of the nearly 800,000 providers registered in the UPD system, more than 75,000 are registered in New York. The UPD service helps health professionals and organizations in their efforts to save time and reduce costs associated with the accurate collection and sharing of provider data required for credentialing and other administrative purposes.

"UPD will enhance provider enrollment for our Medicaid office and simplify the credentialing process. UPD is a trusted service and an important resource in our efforts to reduce administrative burden and cost," said Rachel Block, deputy commissioner for Health Information Technology at the New York State Department of Health.

UPD will give the state quick and easy access to information such as practice locations, services provided, languages spoken and more for registered Medicaid providers. It is a secure, real-time, interactive solution that enables immediate access to any changes made by providers to their data. The system captures and stores provider enrollment, training, experience, and directory demographics that support primary source verification.

Many providers in New York are already familiar with UPD; the credentialing application is accepted by health plans, hospitals, and other healthcare organizations operating throughout the state. The data can also be used by New York Medicaid to offer enrollees up-to-date information on providers.

"We are pleased that New York Medicaid has selected the Universal Provider Datasource to supplement its program administration," said Robin Thomashauer, executive director of CAQH. "The UPD is valued by providers, health plans and hospitals nationwide as a tool for reducing the time and expense associated with network enrollment."

About CAQH

CAQH, a nonprofit alliance of health plans and trade associations, serves as a catalyst for healthcare industry collaboration on initiatives that simplify and streamline healthcare administration. CAQH solutions help promote quality interactions between plans, providers and other stakeholders, reduce costs and frustrations associated with healthcare administration, facilitate administrative healthcare information exchange and encourage administrative and clinical data integration. Visit www.caqh.org for more information.

About Universal Provider Datasource

CAQH launched UPD to enable providers and other health professionals in all 50 states and the District of Columbia to submit required information for credentialing and other purposes. The online service is the industry standard for collecting provider data used in credentialing, claims processing, quality assurance, emergency response, member services, and more. UPD simplifies the initial provider application and re-credentialing processes. All data submitted by providers through the UPD service is maintained by CAQH in a state-of-the-art data center and can only be accessed by the registrant and authorized hospitals, health plans, and other healthcare organizations.

UPD complements the direction being taken by the Medicaid Information Technology Architecture (MITA), which is being built to improve administrative processes for Medicaid programs. CAQH estimates that, to date, the UPD service has eliminated 2.36 million legacy credentialing applications, reducing provider administrative costs by more than $92 million per year or over 3.1 million hours. Visit www.caqh.org/ucd.php for more information.

SOURCE CAQH