CIGNA ACHIEVES CORE PHASE I CERTIFICATION
Nearly 600,000 Providers Nationwide Can Access Streamlined Eligibility and Benefits Data From One of the Nation’s Largest Plans
CAQH® announced today that CIGNA has earned certification for electronically exchanging administrative data, for more than 11 million medical customers, using the CAQH Committee on Operating Rules for Information Exchange® (CORE®) Phase I operating rules. The CORE rules are improving the flow and data content of administrative exchanges between providers and health plans.
CIGNA joins 50 organizations or products that have adopted these voluntary, industry-wide operating rules. CORE Phase I-certified health plans cover more than 85 million lives, or roughly 40 percent of the commercially insured. Hospitals, physicians and healthcare professionals in the CIGNA network now have improved real-time access to patient eligibility and benefits data. This streamlined approach to accurate and consistent information enables more time for physicians and other healthcare professionals to focus on patient care.
“CIGNA is pleased to achieve CORE certification, as these rules improve the information flow between us and the healthcare professionals in our networks, leading to more efficient and cost-effective administration,” said Dr. Alan Muney, CIGNA senior vice president, total health and network. “This is just one of the ways we are working to be the partner of choice for healthcare professionals and to improve the experience of the people we serve.”
In the effort to enhance operations and encourage widespread adoption of the rules, CIGNA is encouraging its trading partners to become CORE-certified. Access to eligibility and benefits data is improved with every organization that completes the certification process.
“Achieving CORE Phase I certification positions CIGNA as a leader in bringing interoperability to healthcare. Changing its daily business practices to streamline administrative processes for providers will result in tremendous savings both in time and resources. This is ultimately leading to an improved consumer experience,” said Marilyn Miceli, vice president, managed care, Memorial Healthcare System, Ft. Lauderdale, Florida.
The CORE rules complement the approaches outlined by the Federal Health Information Technology for Economic and Clinical Health (HITECH) Act, which is part of the American Recovery and Reinvestment Act (ARRA). Additionally, these operating rules incorporate requirements for items such as adopting standards and requiring data delivery in real-time, making CORE well aligned with other national health information technology efforts.
The objectives to generate cost savings, promote the adoption of a single set of rules, and enhance interoperability in healthcare are inherent to CORE. In order to achieve these objectives, the CORE rules include both infrastructure and data content requirements that assist with securely streamlining electronic patient data exchanges across the wide range of current information technology systems.