Edifecs Launches Updated Testing Platform for CAQH CORE Certification

CORE Operating Rules Work in Unison with HIPAA Version 5010 Standards

Washington, D.C. and Bellevue, Wash. - 5/16/11

CAQH® and EdifecsTM today announced the launch of an updated online platform for certifying conformance with the Committee on Operating Rules for Information Exchange®(CORE®) operating rules. Edifecs, a CORE-authorized testing vendor, is providing the updated testing platform which supports the Health Insurance Portability and Accountability Act (HIPAA) Version 5010 transactions and associated errata (v5010).

The CORE operating rules build upon and work in unison with industry standards to streamline administrative exchanges. The rules are updated whenever federal or state regulations mandate a change to an underlying standard. The original set of CORE operating rules and related test suites were developed based on HIPAA Version 4010 transactions (v4010).

Effective January 1, 2012, HIPAA-covered entities will be required by federal regulation to comply with HIPAA v5010 transactions and associated errata. Some of the CORE v4010 operating rules requirements have been incorporated into HIPAA v5010 and are therefore not included in the updated CORE v5010 operating rules. The CORE website includes a Summary of v5010 Updates detailing the changes.

CORE certification is voluntary and achieved by organizations that can demonstrate their systems operate in accordance with the CORE operating rules, which improve provider access to patient benefits coverage and financial information at the point-of-care.

With the launch of the updated testing platform, Edifecs has applied the CORE operating rule updates that reflect HIPAA v5010 requirements and associated errata. Healthcare entities and their vendors pursuing CORE certification now have the option of accessing a free online testing service for either HIPAA v4010 or v5010.

“By offering this updated platform, Edifecs is demonstrating its strong commitment to providing multi-stakeholder solutions that streamline administrative exchanges. Responding to the market transition to the latest version of HIPAA standards, the v5010 testing platform enables organizations interested in pursuing CORE certification to concurrently stay up-to-date with the CORE operating rules and industry standards,” said Gwendolyn Lohse, managing director of CORE and deputy director, CAQH.

More than 35 health plans, large provider groups and health information technology vendors have used the Edifecs CORE Testing Online Service to become CORE-certified. UnitedHealth Group is the first organization to become CORE-certified using the updated CORE operating rules and the Edifecs v5010 testing platform.

“We recognize that interoperability among healthcare entities is critical to streamlining administrative processes and improving the overall quality of care,”said Sunny Singh, CEO of Edifecs, Inc. “Edifecs is pleased to be partnering with CAQH CORE to bring to market tools and services that will help advance this important initiative in compliance with current mandates.”

On May 19, 2011, at 2pm EDT, CAQH CORE and Edifecs are hosting a special webinar featuring a presenter from UnitedHealth Group. The presentation will focus on CORE certification using the v5010 testing platform. Go to www.edifecs.com/webinars to register for this complimentary webinar.

About Edifecs, Inc.
An industry leader since 1996, Edifecs provides healthcare software solutions that improve operational performance by streamlining the exchange of information between health plans, hospitals, and other healthcare organizations, while enabling compliance with current mandates such as HIPAA v5010 and ICD-10.

Today, more than 250 healthcare customers use Edifecs technology to unify transactions from any information channel source and input mechanism, while automating manual business processes such as enrollment, claims and payments management.

Edifecs is currently recognized as one of the 100 Fastest Growing Private Companies in the state of Washington, 100 Best Places to Work for in the state of Washington, an Inc. 5000 fastest-growing private company and one of the 500 Fastest Growing Companies in North America by Deloitte. Edifecs is headquartered in Bellevue, WA. For more information, please visit www.edifecs.com.

About CAQH and CORE
CAQH serves as a catalyst for industry collaboration on initiatives that simplify healthcare administration for health plans and providers, resulting in a better care experience for patients and caregivers. CAQH solutions help promote quality interactions between plans, providers and other stakeholders; reduce costs and frustrations associated with healthcare administration; facilitate administrative healthcare information exchange; and encourage administrative and clinical data integration. Visit www.caqh.org for more information.

A CAQH initiative, CORE has convened more than 120 healthcare industry stakeholders as participants in developing the CORE rules. Learn more about the CORE operating rules. A range of entities participate in CORE, including providers, hospitals, associations and states. Participating health plans cover more than 150 million lives, or approximately 75 percent of the commercially insured, plus Medicare and state-based Medicaid membership. More information is available at www.caqh.org/benefits.php.

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