Administrative simplification

Administrative simplification refers to the Washington Healthcare Forum (the Forum) effort to simplify administrative processes between providers and health plans. The Forum convened to create consistent policies that will reduce paperwork and improve cash flow for health care providers and health plans alike.

The Forum members are working to coordinate electronic health care transactions, discuss common problems, and develop effective strategies for improvement. They began by addressing three key areas:

• Prior authorization
• Claims
• Credentialing

From there, work groups developed policies and guidelines to resolve key administrative issues.

The Forum is sponsored by Kaiser Permanente and other health care leaders throughout Washington state. Participants include providers, health plan representatives, and purchasers.

Goals shared by all participants include:

• Increasing the efficiency of health care financing and delivery systems.
• Decreasing the hassle and non-productive work between providers and health plans.

The Forum has created 10 policies and procedures for administrative simplification. The WorkSmart Web site contains current policies along with details of new initiatives that The Forum is developing. Make a note to visit this site periodically because policies and procedures may change over time.

We encourage you to share and adopt these policies. They can streamline how you work with us, save valuable staff time, and reduce your administrative costs.