ZirMed, a Louisville, Ky.-based claims clearinghouse, has been certified as supporting Phase I of the CORE operating rules to significantly tighten the HIPAA financial/administrative transactions.
CORE is the CAQH Committee on Operating Rules for Information Exchange initiative from CAQH, a Washington-based alliance of payers and trade associations. The goal of CORE is to make 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.
CORE started with Phase I of a basic electronic eligibility/benefit determination transaction. Recently completed Phase II of CORE further tightened the eligibility/benefit determination transaction by including year-to-date deductibles among other functions, and also includes real-time claims status. Several vendors and insurers have received Phase II certification. CORE participants will develop additional transactions in subsequent phases. More information is available at caqh.org/core and zirmed.com.
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