CORE is the CAQH Committee on Operating Rules for Information Exchange initiative, which focuses on making electronic claims and related transactions as easy to conduct as an ATM transaction. The health reform law mandates use of a series of operating rules between 2013 and 2016.
Bloomfield, Conn.-based Cigna joins about 50 other payers and organizations in Phase 1 certification, which covers an electronic eligibility/benefit determination transaction. The recently completed Phase II of CORE further tightened the eligibility/benefit determination transaction and included claims status. At least 17 insurers and 11 vendors have been certified in Phase II. More information is available at caqh.org/core.
--Joseph Goedert
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