CAQH CORE Simplification Initiative Presses Forward

CAQH, the national organization serving as a catalyst for healthcare industry collaboration on initiatives that simplify and streamline healthcare administration, today announced that four more organizations have joined in its national initiative to streamline patient insurance coverage verification before or at the point of care.

The CAQH Committee on Operating Rules for Information Exchange (CORE) to create an all-payer solution that gives providers access to insurance information before or at the time of service using the electronic system of their choice for any patient or health plan. The CORE rules, developed by more than 100 healthcare industry stakeholders, are built on existing national standards, such as HIPAA.

A multi-phased initiative, CAQH expects to launch the CORE Phase II rules in July 2008. CORE’s second set of rules builds on those from Phase I, with additional rules for patient identifiers, patient accumulators, claims status and connectivity. Phase II also requires reporting of patient financial responsibility for an increased number of service codes.

CAQH has already begun work on the CORE Phase III rules, which will focus on improving the electronic exchange of additional administrative transactions, such as prior authorization.

CAQH solutions help promote quality interactions between plans, providers and other stakeholders, reduce costs and frustrations associated with healthcare administration, facilitate administrative healthcare information exchange and encourage administrative and clinical data integration.

Visit www.caqh.org for more information