Simplify Health Care Administration
Contain Health Care Cost
The Department of Banking, Insurance, Securities and Health Care Administration (BISHCA) is charged with adopting regulations designed to simplify the claims administration process, and to lower administrative costs in the health care financing system.
Vermont’s health care legislation created a Common Claims and Procedures Work Group charged with designing, recommending and implementing steps to:
- Simplify the claims administration process for consumers, health care providers, and others so that the process is more understandable and less time-consuming; and
- Lower administrative costs in the health care financing system.
Convened by the Vermont Association of Hospital and Health Systems (VAHHS), this workgroup submitted a two-year work plan and budget to the Governor and the legislature in September, 2006, and submitted an interim report in January 2007. The Common Claims and Procedures Work Group Final Report was submitted in January 2008.
As another effort to simplify health care administration, BISHCA was charged with prescribing a standard credentialing application form to be used by insurers and hospitals for credentialing their providers.
In December 2006, BISHCA issued Bulletin HCA - 122, Uniform Provider Credientialing, which prescribes the use of the Council for Affordable Quality Healthcare (CAQH) credentialing application form by health insurers and hospitals that perform credentialing of providers beginning January 1, 2007. Insurers and hospitals are required to inform providers of deficiencies in their applications, according to statutory timeframes.
