CORE Exceeds 300 Certifications Milestone

April 2017

CAQH CORE announced that it has awarded more than 300 CORE Certifications to health plans, hospitals and health systems, clearinghouses and vendors with recent Aetna and Cigna awards. The continued increase in the number of organizations seeking and receiving certification underscores the value they place on demonstrating that they meet – and exceed – the CORE operating rules and underlying standards for electronic business transactions.  

A new CORE Certification Progress Report found that health plans certified in Phases I and II cover 76 percent of commercially-insured and 44 percent of publicly insured Americans. Further, the report showed that health plans certified in Phase III covers 27 percent of the commercially insured, and 25 perfect of publicly insured.

CAQH CORE will be expanding the progress report to include healthcare providers. Real interoperability across the healthcare economy can only be achieved when both health plans and providers follow the same set of operating rules. The report will measure transactions conducted between the two by working with practice management companies and other CORE Certified vendors that enable providers to exchange data with health plans. The results will be available in a new report later this spring.

Learn more about the CORE Certification Progress Report and CORE Certification

Congratulations to the following entities receiving CORE Certification in 2017 (to date).

Aetna – Phase III
Boston Medical Health Plan – Phase I, II
Cooperative Managed Care Services – Phase I-III
Eligible – Phase I, II, III
GE Healthcare, Financial Risk Manager – Phase I-III
HIPAAsuite – Phase III
Rocky Mountain Healthcare – Phase I, II

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