Frequently Asked Questions

• Who is The Washington Healthcare Forum?

The Washington Healthcare Forum (the Forum) is a coalition of health plans, physicians, hospitals, and purchasers, that has joined together to improve the health care system.

Our vision is an efficient and effective healthcare financing and delivery system that addresses the needs and concerns of patients, providers, health plans, and purchasers.

Our mission is to:

• Streamline and simplify healthcare financing and delivery across the state
• Advance a public dialogue on sustainable solutions to the challenges facing the health care system

Our philosophy: We believe individuals, policy makers, purchasers, and others should be able to make informed choices. We believe in a sustainable and affordable health care system that addresses the critical health care needs of all our citizens. Access to affordable health care is essential, whether you're using it, purchasing it, administering it, or providing it.

To see a roster of the individuals and organizations that make up the Forum, click here.

• Who determines the Forum's agenda?

The Forum's Board of Directors ultimately decides which projects the Forum will work on and the appropriate funding for these activities.

• Who does the work?

The Forum's work in the area of administrative simplification is directed by the Administrative Simplification Steering Committee. This group develops project work plans and budgets, monitors the progress of the work, and organizes and implements educational workshops to train staff from health plans and provider organizations on Forum developed simplification solutions.

Once project plans and budgets are approved by the Board of Directors, the Steering Committee forms Work Groups that carry out the work of one or more projects. We also use what we call Respondent Groups as an extension of our Work Groups. Respondent Groups use e-mail to provide the Work Groups with input during both the problem definition and solution development phases of the work.

• Who pays for this work?

The work of the Forum is paid for with in-kind contributions from Forum members, their staff, and staff of other participating organizations, as well as cash contributions from Forum participants to cover project facilitation and communications activities.

• What have you done so far?

Our first round of administrative simplification activities concluded in the spring of 2002 with a series of educational workshops. In this initial phase we developed 10 policies/guidelines in three focus areas: claims processing, referrals and prior authorizations, and practitioner credentialing.

• What if I have a suggestion for a worthwhile project?

The best way to get the Forum to consider your ideas for administrative simplification projects is to contact a member of the Administrative Simplification Steering Committee.

• I have a question about one of the policies. How can I get that addressed?

Many of the policies and guidelines developed by the Forum contain contact information specific to each policy/guideline. That should be your first contact if you have questions. If you have further questions, contact a member of the Administrative Simplification Steering Committee.

• Is this a government program?

No. The Forum is a collaborative private sector initiative that is not sponsored by or reporting to any governmental entity. The Forum has no authority to mandate the use of its administrative simplification solutions to either health plans or providers.

• Won't HIPAA solve all of the administrative simplification problems?

The Forum sees significant value in working to collaboratively implement the mandates of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). We have several projects underway in this area, click here for our HIPAA Services.

Sadly, however, HIPAA will not address many of the most frustrating, time consuming, and costly complexities of today's health-care system. That is why the Forum's administrative simplification activities go far beyond HIPAA into areas such as claims processing, referrals and prior authorizations, and practitioner credentialing.

• Is the Forum part of a national effort?

No. We believe the adage that healthcare is fundamentally local. A large part of our success to date has been due to the hands-on involvement and commitment of the Chief Executive Officers of the participating organizations who sit on the Board of Directors. We think our methods and our solutions can serve as a model for collaborative work elsewhere but our focus will remain on Washington State.

• What else is The Forum doing?

In addition to work on administrative simplification, the Forum is carrying out several efforts related to HIPAA implementation, has spun off a new corporation to address electronic security solutions, and is also becoming active in areas of public policy.

• Can I get regular updates on Forum administrative simplification activities?

Yes. We will distribute electronic notices of additions and revisions to our administrative simplification policies and guidelines. These notices will also advise interested parties of upcoming educational opportunities sponsored by the Forum. To receive these electronic notifications, we need you to give us some contact information. To get on our Email Updates list, click here.

• Are there areas that you are explicitly not collaborating on?

The Forum does not participate in any anti-competitive activities. All proposed activities are reviewed by legal counsel as part of the Board's approval process.

• How can I use the Forum activities to help my practice reduce administrative overhead?

Several ways. First of all, we recommend that you begin implementing the policies/guidelines already developed by the Forum. Second, attend Forum educational workshops to learn about new policies/guidelines. Third, sign up to be on our Email Updates list so you will get early notification of new policies/guidelines and other information. And finally offer your time and expertise as a member of a Forum Work Group or Respondent Group as we identify problems and develop solutions.