2022 Fall Conference - Opportunities to Reduce Administrative Burden and Cost: New CAQH CORE Operating Rules - HBMA Store

Opportunities to Reduce Administrative Burden and Cost: New CAQH CORE Operation Rules Presented by Robert Bowman

As presented at HBMA's 2022 Fall Conference September 15th-17th, 2022.
This program is valid for 1 CHBME credit

Description:
Across the healthcare industry, the time and money spent on administrative functions are significant, resulting in fewer resources for quality patient care. CAQH CORE is designated by the Department of Health and Human Services as the national operating rule author to improve the accuracy and effectiveness of healthcare business transactions across the revenue cycle. In early 2022, CAQH CORE published new and updated operating rules to support the industry's need for simplified attachments workflows to exchange documentation for prior authorization and claims, delivery of robust eligibility and benefit coverage information, and adjusted system availability requirements. Speakers will discuss key rule requirements, describe impact on revenue cycle performance, and present a call to action. Speakers will contextualize this overview within the results of the 2021 CAQH Index, an annual benchmark report which tracks the adoption of electronic administrative transactions. Specific to this year, speakers will also deliver insights into how COVID-19 impacted medical billing workflows. Session participants will learn about workflow inefficiencies and opportunities for improvement, including how adoption of the latest CAQH CORE Operating Rules reduces the cost and time associated with certain administrative tasks.

Objectives:

• Summarize the industry-wide effort to identify challenges regarding the electronic exchange of healthcare information across key revenue cycle processes.
• Describe how the development and implementation of operating rules can yield efficiencies in electronic data transactions across the industry, saving you time and money.
• Describe how New CAQH CORE Operative Rules address industry pain points related to attachments, eligibility and benefits, and infrastructure.