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.