CORE: Advancing Electronic Data Exchange and Connectivity
The benefits of an interoperable healthcare system are well understood. The availability of information in real-time at the point of care can reduce medical errors, allow physicians and their patients to make informed decisions about treatment options, and reduce administrative burdens. The challenges are equally well understood. Technology adoption rates, data security, and inconsistency associated with transactions and interactions between stakeholders limit the ability to realize a complete solution.
Through CORE, CAQH is working to make it easier for physicians and hospitals to access patient insurance information before or at the point of care. CORE operating rules are streamlining eligibility, benefits, and claims data by allowing providers to submit a request, using the electronic system of their choice, to obtain a variety of coverage information for any patient and from any participating health plan. Providers will receive more consistent and predictable data, regardless of health plan.
HHS Extends Comment Period through April 3, 2014 is Accepting Comments on its Proposed Rule (NPRM), Administrative Simplification: Certification of Compliance for Health Plans, through March 3, 2014.
Self-funded health plans and all Industry stakeholders are encouraged to participate in the CAQH CORE efforts to respond to the proposed rule. CAQH CORE has collected is collecting industry comments on the NPRM and has developed will develop a model comment letter reflecting this input. View the schedule and more information here.
The Implementation Deadline for Federally-mandated CAQH CORE EFT and ERA Operating Rules was January 1, 2014.
Learn more about CAQH CORE resources available to help your organization meet the Patient Protection and Affordable Care Act's operating rule mandate.
CORE Town Hall Calls
To hear an update on CORE activities, attend the next public CORE Town Hall Call for non-CORE and CORE participants.
Preparing for the January 1, 2014 implementation deadline for the Federally mandated CAQH CORE EFT and ERA Operating Rules?
Email CAQH CORE for clarifications, interpretations or general requests at email@example.com.