CORE-Certified Organizations/Products
View pending and current CORE certifications below. Voluntary CORE Certification is currently available for entities that exchange the X12 270/271 Eligibility & Benefits Request/Response and X12 276/277 Claim Status Inquiry/Response transactions, i.e., providers, health plans, clearinghouses, and vendors.
Organizations ready to adopt the CAQH CORE Operating Rules should click here to view recommended milestones for achieving voluntary CORE Phase II-certification.
View endorser organizations by visiting the CORE Endorsers page. Organizations that do not use, create, or transmit eligibility and/or claim status data can demonstrate their support for CORE’s mission and its rules by signing the CORE Pledge, and applying for and using the CORE Endorser Seal.
Health Plans
| Organization | Certified Phase(s) (Committed Phase(s)) |
|
| Aetna, Inc.+ | ![]() |
Phase I Phase II |
| Anthem Colorado* | Phase I Phase II |
|
| Anthem Connecticut* | Phase I Phase II |
|
| Anthem Indiana* | Phase I Phase II |
|
| Anthem Kentucky* | Phase I Phase II |
|
| Anthem Maine* | Phase I Phase II |
|
| Anthem Nevada* | Phase I Phase II |
|
| Anthem New Hampshire* | Phase I Phase II |
|
| Anthem Ohio* | Phase I Phase II |
|
| Anthem Virginia* | Phase I Phase II |
|
| AultCare | ![]() |
Phase I Phase II |
| AvMed Health Plans | Phase I | |
| Blue Cross of California* | Phase I Phase II |
|
| Blue Cross Blue Shield of Georgia* | Phase I Phase II |
|
| Blue Cross Blue Shield of Missouri* | Phase I Phase II |
|
| Blue Cross Blue Shield of North Carolina | ![]() |
Phase I (Phase II Committed) |
| BlueCross BlueShield of Tennessee | ![]() |
Phase I Phase II |
| Blue Cross Blue Shield of Wisconsin* | Phase I Phase II |
|
| CIGNA++ | ![]() |
Phase I |
| Empire Blue Cross Blue Shield* | Phase I Phase II |
|
| Harvard Pilgrim Health Care | ![]() |
Phase I Phase II |
| HealthNet | ![]() |
Phase I Phase II |
| Humana** | ![]() |
Phase I (Phase II: Committed) |
| UnitedHealth Group*** | ![]() |
Phase I Phase II |
| WellPoint | ![]() |
Phase I Phase II |
Providers
| Organization | Certified Phase(s) (Committed Phase(s)) |
|
| Mayo Clinic | ![]() |
Phase I (Phase II: Q1 2011) |
| Montefiore Medical Center | ![]() |
Phase I Phase II |
| Spectrum Laboratory Network | Phase I | |
| Summit Medical Group | ![]() |
Phase I |
| U.S. Department of Veterans Affairs | ![]() |
Phase I |
| Wake Forest University Health Sciences | Phase I |
Clearinghouses
| Organization Product |
Certified Phase(s) (Committed Phase(s)) |
|
| ACS EDI Gateway, Inc., a Xerox Company ACS EDI Direct |
![]() |
Phase I Phase II |
| Availity, LLC Availity Health Information Network |
![]() |
Phase I Phase II |
| Capario (Formerly MedAvant Healthcare Solutions) Phoenix Processing System |
![]() |
Phase I Phase II |
| Emdeon Inc. Real – Time Transaction Processing and Data Hosting Services |
![]() |
Phase I Phase II |
| eServices Group Inc. Unite |
![]() |
Phase I Phase II |
| Gateway EDI RTE Individual & Integrated Transactions |
Phase I | |
| HealthFusion Healthfusion RT |
![]() |
Phase I |
| HMS HMS |
![]() |
Phase I |
| InstaMed InstaMed Platform and Network |
![]() |
Phase I Phase II |
| MD On-Line, Inc. ACCE$$ Patient Eligibility Verification |
![]() |
Phase I |
| MedData MedConnect |
![]() |
Phase I |
| NaviNet NaviNet |
![]() |
Phase I Phase II |
| Netwerkes, LLC Netwerkes.com Real Time Eligibility |
Phase I | |
| Office Ally Real Time Eligibility |
![]() |
Phase I |
| OptumInsight OptumInsight Transaction Exchange |
![]() |
Phase I Phase II |
| Passport Health Communications OneSource |
![]() |
Phase I Phase II |
| Post-N-Track Doohickey™ Web Services |
Phase I Phase II |
|
| Practice Insight EDIinsight |
Phase I | |
| RealMed Corporation RealMed Revenue Cycle Management |
Phase I | |
| RelayHealth Real Time Eligibility |
![]() |
Phase I (Phase II: Committed) |
| SecureEDI/Immediata SecureEDI Clearinghouse |
![]() |
Phase I |
| Siemens/HDX Healthcare Data Exchange |
![]() |
Phase I Phase II |
| Surescripts Surescripts Prescription Benefit |
![]() |
Phase I |
| The SSI Group, Inc ClickON E-Verify Suite |
![]() |
Phase I Phase II |
| ZirMed Real Time Eligibility |
![]() |
Phase I |
Vendors
| Organization Product |
Certified Phase(s) (Committed Phase(s)) |
|
| athenahealth athenaCollector |
![]() |
Phase I Phase II |
| CSC CSC DirectConnect® |
![]() |
Phase I (Phase II: Q1 2011) |
| EmergingHealth TREKS |
![]() |
Phase I |
| eServices Group, Inc. XJ Series Gateway Services |
![]() |
Phase I Phase II |
| GE Healthcare Centricity Business Version 4.0 and Version 4.3 |
Phase I | |
| GE Healthcare Centricity Business Version 5.0 |
Phase I Phase II |
|
| HealthTrio, LLC connect |
![]() |
Phase I Phase II |
| Medical Informatics Engineering WebChart EMR |
![]() |
Phase I |
| Medical Present Value, Inc. (MPV) MPV Eligibility |
![]() |
Phase I |
| NoMoreClipboard.com NoMoreClipboard.com |
![]() |
Phase I |
| Recondo Technology Eligibility Plus |
![]() |
(Phase I: Q2 2011) (Phase II: Q2 2011) |
| Recondo Technology SurePayHealth |
![]() |
Phase I Phase II |
| RelayHealth Payor Connectivity Services (PCS) |
![]() |
Phase I Phase II |
| RelayHealth RevRunner |
![]() |
Phase I (Phase II: Committed) |
| The SSI Group Inc ClickON E-Verify Suite |
![]() |
Phase I Phase II |
| VisionShare Secure Exchange Software Interactive |
![]() |
Phase I (Phase II: Q1 2011) |
*Indicates a WellPoint company
As permitted by CORE policy, the following health plans have some exemptions (affecting less than 30% of their membership), given system migrations already underway or recent mergers at the time of CORE-certification. Also per CORE policy, within 12 months of the plan’s CORE-certification all exemptions will be addressed to operate in accordance with the CORE rules:
+System migrations are underway in 2012 to ensure the following Aetna products run over CORE certified platforms: Aetna Medicaid®, Aetna Student Health®, Aetna Joint Claim Administration®, Aetna Affordable Health Choices®.
++The following CIGNA products will be migrated to CORE certification within 12 months, with a targeted implementation of 4th quarter 2011: CIGNA International Expatriate Business, CIGNA Voluntary, CIGNA Medicare Access PFFS, and limited CIGNA Medicare Advantage HMO.
** The following Humana Inc. subsidiaries will be migrated to CORE certification – Cariten (within 12 months); CarePlus Health Plans, Inc. (longer than 12 months), KMG American Corporation (longer than 12 months), Humana Benefit Plan of Illinois, Inc. (between 1/1/09 – 6/30/10). Humana Military Healthcare Services, Humana Puerto Rico, Humana Dental and CompBenefits Corporation operate out of scope of the CORE rules and are not required to use them.
***The following UnitedHealth Group subsidiaries will be migrated to CORE certification within 12 months, with a targeted implementation of 2nd quarter 2012: United Healthcare Community Plan and United Healthcare Great Lakes Health Plan. Prescription Solutions operates out of scope of the CORE rules and are not required to use the CORE rules.






















































