MAR 13, 2013 11:55am ET

Related Links

New WEDI Program Facilitates State ICD-10 Cooperation
May 22, 2013
AMA Board to Members: Skipping ICD-10 for ICD-11 Not Recommended
May 16, 2013
Web Seminar to Focus on Using Direct Messaging in Stage 2
May 15, 2013
Allscripts Stock Dips on Poor First Quarter
May 10, 2013
CMS: Deadline Nears to Avoid Medicare eRx Payment Penalty
May 8, 2013
The Fight to Better Manage Revenues
May 7, 2013
New Leaders at Software Vendor TriZetto
May 6, 2013

Payers Work to Ease Coordination of Benefits Determinations

Print
Reprints
Email

Industry advocacy organization CAQH, which has developed the CORE operating rules to make HIPAA transactions more uniform, has a new initiative to streamline the coordination of benefits process.

All 12 health insurer members of CAQH have pledged to adopt the new COB process when it’s complete, which should happen later this year. Covering a combined 165 million members, the members are Aetna, AultCare, Blue Cross Blue Shield of Michigan, Blue Cross and Blue Shield of North Carolina, BlueCross BlueShield of Tennessee, CareFirst BlueCross BlueShield, Cigna, Health Net, Horizon Healthcare Services, Kaiser Permanente, UnitedHealth Group, and WellPoint and its affiliated plans.

The payers are building a shared repository of patient demographic data to match and compare records from different health plans to identify patients with overlapping coverage from more than one insurer. The goal is to electronically identify and assess payer responsibilities, a primarily manual and often inaccurate process, when a patient has coverage from more than one insurer.

The registry will be open to all commercial and government payers, says Robin Thomashauer, executive director at CAQH. The registry also is the latest initiative of the organization to reduce administrative complexities and costs in the transactions processing arena. In addition to the CORE initiative, CAQH also offers the Universal Provider Datasource, a database to share credentialing and other professional information among insurers and provider organizations; and a new electronic funds transfer enrollment tool to enable one-stop shopping for providers to enroll in EFT with health insurers.

Comments (0)

Be the first to comment on this post using the section below.

Add Your Comments:
You must be registered to post a comment.
Not Registered?
You must be registered to post a comment. Click here to register.
Already registered? Log in here
Please note you must now log in with your email address and password.
Twitter
Facebook
LinkedIn

As the feds ramp up enforcement of privacy and security rules, providers look to fill protection gaps.

Login  |  My Account  |  White Papers  |  Web Seminars  |  Events |  Newsletters |  eBooks
FOLLOW US
Already a subscriber? Log in here
Please note you must now log in with your email address and password.