UnitedHealthcare, Cigna and Centene are among the initial participants in a national shared provider credentialing program, launching in the fall.
CertifyOS, a provider data intelligence company, announced the program Sept. 23. The initiative aims to standardize credentialing and verification, speed up the time to join an insurance network and serve as a reliable source of truth on provider data.
“Healthcare providers often face duplicative credentialing requirements that create unnecessary complexities,” Mike Kane, UnitedHealthcare’s senior vice president of provider data operations, said in a CertifyOS news release. “This model will help streamline that process and allow providers to spend more time focused on patient care.”
For each provider, health plans spend $200 to $500 per recredentialing cycle, while providers submit an average of 17 applications per year, according to CertifyOS. The company said the American healthcare system spends more than $2 billion annually on provider credential verification, but a unified approach could save as much as 75% of that.
Health plans using the service will share their recredentialing rosters with CertifyOS, which will manage the primary source verification while adhering to National Committee for Quality Assurance and Medicaid standards. Providers will enter their CAQH, now DataSpring, identification and other necessary information once through the CertifyOS portal.
Becker’s contacted UnitedHealthcare, Cigna and Centene for comment and will update this story if more information becomes available.
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