CORE Overview Presentation
CORE Provider Presentation
January 2013 Operating Rules Deadline
Is Your Organization Ready to Test Operating Rules with Trading Partners?
Why: The administrative simplification provisions in Section 1104 of the Patient Protection and Affordable Care Act (ACA) require all HIPAA-covered entities to adopt the Phase I & Phase II CAQH CORE Eligibility and Claim Status Operating Rules by January 1, 2013. Given the deadline, entities should be testing their operating rules implementation to identify any challenges.
Who: Organizations that are ready to test operating rules implementation with trading partners are highlighted below.
- Your organization may submit its name and contact information for inclusion on this list.
- Your organization may use the list to identify and connect with trading partners that are also ready to test.
How: Use the button below to submit the name of your organization and a contact to appear on this list. CAQH will update the list within one business day from the time the request is received.
Organizations are encouraged to reference this list frequently to identify additional trading partners that are ready for testing.
Health Plans
| Organization Name | Primary Contact Name | Ready to test with trading partners* |
|---|---|---|
| AultCare | Robert Schleichert |
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| BlueCross BlueShield of Tennessee | eBusiness Solutions |
|
| CalOptima | Mary Eden |
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| Harvard Pilgrim Health Care | Rhonda Starkey |
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| HealthPlus of Michigan | Matt Devitt |
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| Mutual of Omaha | Kent Dewell |
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| SelectHealth | Malene Davis |
|
Clearinghouses
| Organization Name | Primary Contact Name | Ready to test with trading partners* |
|---|---|---|
| athenahealth, Inc. | Amy Yeh |
|
| Checkmedicare.com | Ken Katz |
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| ClaimRemedi | Karin Bowhall |
|
| Dorado Systems | Edward Kennedy |
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| Emdeon | Jason T. Garrett |
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| HMS | Joseph Cunningham |
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| InstaMed | Brendan Crotty |
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| Netwerkes | Nick Reidy |
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| Office Ally | Richard Long |
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| OptumInsight | Rhonda Sapereira |
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| Practice Insight | Martha Johnson |
|
| RelayHealth | Brian Eidex |
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| The SSI Group | Mary Hyland |
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| ZirMed Inc. | Crystal Ewing |
|
Providers
| Organization Name | Primary Contact Name | Ready to test with trading partners* |
|---|---|---|
| Blue Ridge Medical Transport | Debbie Poe |
|
| Boston Brace International Inc NOPCO | Melisa Vitagliano |
|
| Dr. Anna B. Miller Eye Care Center | Sarah Benard |
|
| Elite Medical | Michelle Stevens |
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| Family Healthcare Affiliates | Krystal Urban |
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| Gifford Medical Center | Leslie Papa |
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| Montefiore Medical Center | Noam Nahary |
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| Ormond Beach Dermatology | Sandra Adams |
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| Primary Care Health Partners | Jon Asselin |
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| Serra Community Medical Clinic, Inc. | Ziad Kalioundji |
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| Springfield Nephrology Associates, Inc. | Ashley Dees |
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| Valley Day and Night Clinic | Monica Garza |
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| VMH Community & Home Care | Holly Palmer |
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| Wesley Manor Retirement Community | Jerry Hoganson |
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*The CORE-certification Seal signifies that an entity is using the CORE operating rules in daily business. CAQH awards CORE Certification Seals to entities that create, transmit or use the administrative transactions addressed by the CAQH CORE Operating Rules. Voluntary CORE Certification is available for providers, health plans, clearinghouses, and vendors that successfully complete the CORE testing and certification process. See the website for Edifecs, a CORE-authorized testing vendor, for CORE-required testing that must be conducted in order to apply to CORE for a CORE Certification Seal.