THIRD NATIONAL MEDICAL BANKING INSTITUTE

February 24-25, 2005

Nashville, TN

Institute Home | Registration | Agenda | Speakers | Institute Materials | Location & Lodging | Sponsorship

Carl Volpe, PhD

Vice President, Strategic Initiatives

WellPoint, Inc.

Thousand Oaks, CA

Title:  CAQH Eligibility and Benefits Operating Rules Initiative

Session Focus/Summary:

Similar to operating rules governing interoperability for ATM transactions, CAQH is facilitating a multi-stakeholder effort to develop business rules that govern the exchange of eligibility and benefits information. The result will be standard processes and content for eligibility transactions between healthcare providers and payers.  Session participants will understand the goals, scope and structure of the CAQH initiative and opportunities for involvement.  As the initiative will impact the business of participating payers, vendors, and providers, these stakeholders will be especially interested in attending.

Learning Objectives:

1. Understanding of the goals, scope and structure of the CAQH eligibility and benefits operating rules initiative as well as an update on its progress

2. Understanding of how participants can participate in the CAQH eligibility and benefits operating rules initiative and how the initiative will positively impact the daily business of payers, vendors, and all types of providers

3. Understanding of how the CAQH eligibility and benefits operating rules initiative will assist the industry in communicating key administrative data at the point of care.

Biography:

L. Carl Volpe is Vice President for Strategic Initiatives at WellPoint Health Networks.  He is responsible for strategic projects to improve services and the quality of care to WellPoint members.  Additionally, he is responsible for strategies to communicate WellPoint's medically-related programs and initiatives.  Prior to his current position, he led a team that assessed and responded to the business impact of state and federal health legislative proposals.  Volpe was health legislation Director of the National Governors' Association in Washington, DC, and was their representative on President Clinton's Health Care Task Force.  He held several Texas Department of Human Services positions including Health Policy Initiatives Director in Texas Medicaid.  Volpe's expertise includes market-based healthcare, network-based healthcare systems, healthcare financing and state/federal relationships in public and private health reform.  He holds a faculty position at UCLA's School of Public Health; has a Ph.D. in experimental psychology from Northeastern University and was a post-doctoral fellow in applied psychology and evaluation at St. Louis University.