CAQH Directory Maintenance Toolkit

Dear Colleagues,

The National Medical Group Management Association (MGMA) has asked we distribute the CAQH (Council for Affordable Quality Healthcare) provider directory maintenance toolkit. Many of you have already been working with CAQH for credentialing. With health plans now required to regularly update their directories, CAQH is exploring opportunities to capture this information one-time for multiple health plans, thus reducing the burden on physician practices to supply the information. They are working within a small number of states, including Arizona. There is no cost to your practice for using this toolkit. You will find a Fact Sheet followed by the information for how to use the Toolkit in the PDF attachment. You’ll also find the contact information for CAQH for any questions.


The intent is to simplify the directory update process for physician practices.  AzMGMA will also be monitoring this process and would appreciate hearing from you about successes or concerns.


Best regards,


Michelin Abrahamsen

AzMGMA President


CMS finalizes new regulation to standardize electronic funds transfer

The Centers for Medicare & Medicaid Services (CMS) announced that the interim final rule that adopts healthcare electronic funds transfer (EFT) standards is now a final rule currently in effect. According to CMS, the standards for EFT could reduce administrative costs for physician practices and others by up to $4.5 billion over the next ten years. The rule is the second in a series of regulations mandated by the administrative simplification section of the Affordable Care Act and adopts many of the MGMA recommendations submitted during the public comment period.

The final rule outlines two standards that health plans must comply with in order to use EFT to transmit healthcare claim payments to providers. First, health plans are required to use a standard format when ordering, authorizing or initiating an EFT with their banks. Second, the rule outlines the data content of the EFT.

Health plans and other covered entities must comply with the provisions of the EFT rule by Jan. 1, 2014. However, CMS indicates that health plans are permitted to use the EFT standards with willing trading partners before that date. Practices not already receiving EFT payments should contact their practice management system software vendor and health plans to discuss incorporating this transaction into their claims revenue cycle workflow.

Read the full regulation in the Federal Register.