Benefits of Participating

The Universal Provider Datasource is the industry standard for provider data collection. The UPD yields higher quality credentialing and demographic information than traditional paper processes. With access to comprehensive provider information, you can optimize credentialing workflows, improve provider directories and focus your organization on using data instead of collecting it. Participating health plans have reported one or more of the following efficiencies by using the service:

• Decreased average processing turnaround time by 8 - 10 days
• Reduced frequency of returned provider correspondence due to poor address quality by 80 - 85 percent
• Near elimination (97 percent) of new provider initial credentialing packet mailings
• Reduced number of legacy re-credentialing mailings (e.g. savings reported by one plan: $75,000 - $120,000)
• Reduced sanctions monitoring resources by 56 percent
• Real-time updating of provider directories
• Facilitated implementation of NPI
• Reallocated legacy paper credentialing application storage space
• Assisted with overlap analysis when merging different networks

Flexibility for Unique Plan Needs

CAQH understands that each health plan is unique, and that a credentialing solution must allow plans flexibility. Universal Provider Datasource was designed by health plans to accommodate a wide range of needs:

• Define your own recredentialing cycles
• Receive credentialing information in ASCII, XML or PDF formats
• Determine your own approach for primary source verification
• Phase your implementation to be compatible with organizational priorities
• Select from a variety of tools, including a toll-free support desk, to assist with getting started
• Access additional CAQH services beyond self-reported provider data, such as identifying providers who have received sanctions and other disciplinary actions