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Filed Under:Markets, Employee Benefits

Service aims to end health coverage conflicts


CAQH -- a nonprofit health care administrative simplification group -- has launched a new program.

The group's new COB Smart registry is supposed to ease the problems doctors, hospitals, employer plan sponsors, plan administrators and insurers face when patients have multiple sources of health coverage.

In some cases, for example, a family with two working adults might get private coverage from two employer plans. In other cases, a family might have a combination of private coverage and Medicaid, private coverage and Medicare, or Medicaid and Medicare.

CAQH estimates identifying coverage conflicts and deciding which carrier pays for what services costs the U.S. health care system about $800 million a year.

Many insurers and insurance groups belong to CAQH, and the COB Smart registry already contains plan information for 100 million people, CAQH says.

Project managers are hoping the registry will reduce the time spent on filling out forms and verifying coverage details, CAQH says.

CAQH gives Matthew Manders, a regional and operations manager at Cigna Corp. (NYSE:CI), as an example of an insurance company executive who's hoping the registry will make life easier for patients and care providers as well as for insurers.

CAQH is starting by introducing the registry in 15 states. It hopes to make the registry available in the rest of the country by the end of the year.

In addition to Cigna, the list of carriers that have agreed to support the registry includes Aetna, AultCare, Blue Cross and Blue Shield of North Carolina, BlueCross BlueShield of Tennessee, CareFirst BlueCross BlueShield, Health Net Inc., Horizon Healthcare Services Inc., Kaiser Permanente, UnitedHealthcare and WellPoint Inc.

CAQH earlier developed the Universal Provider Datasource provider credentialing system. That system helps 1.2 million doctors and other professionals give information about their credentials to health plans and hospitals.

See also:



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Nichole Morford

Nichole Morford
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