- Operating Rules
- CORE Certification
- Value-Based Payments
- Industry Topics and Comment Letters
- Education and Implementation Resource Center
- Join CORE
- CAQH ProView
- CAQH ProView for Groups
- CAQH ProView - Dental
- Provider Directory - DirectAssure
- Credentialing Solutions Suite
- COB Smart
- CAQH Index
- Provider Data Collaboration
More than 1 Million Federal Employees Now Covered by CAQH CORE-Certified FEHB Plans
Federal Employees Health Benefits programs achieve CORE Certification to advance interoperability and seamless electronic data sharing
WASHINGTON, DC - 11/1/17–
CAQH CORE®, a collaboration of more than 130 public and private entities across the healthcare industry, has announced that three Federal Employees Health Benefits (FEHB) plans have become CORE-certified. Together, the APWU Health Plan (APWUHP), GEHA and National Association of Letter Carriers Health Benefit Plan (NALC-HBP) cover more than one million federal employees, retirees and their family members.
“Key industry stakeholders are increasingly embracing digital technologies in their business processes for electronic financial and administrative transactions,” said Robin J. Thomashauer, Executive Director of CAQH. “By becoming CORE-certified, these federal health plans highlight the value that the CAQH Operating Rules deliver to healthcare by exchanging data quickly and efficiently.”
Operating rules are used across many industries—from banking to airline reservations—to ensure high volumes of electronic transactions occur smoothly and securely. More than ten years ago, CAQH CORE brought together industry stakeholders to develop operating rules for healthcare business transactions and a voluntary certification program.
Recognizing the need for healthcare operating rules, and building off initial industry progress, in 2010 Congress called for further rule creation and adherence. The Department of Health and Human Services turned to CAQH CORE, which was leading industry adoption of electronic information sharing, to develop additional rule sets. Today, four phases of healthcare operating rules are being used to seamlessly exchange business data across the industry.
Health plans, providers and vendors demonstrate that they are adhering to these rules and underlying standards by achieving CORE Certification. The benefits for industry-wide adoption are considerable: according to the 2016 CAQH Index®, the U.S. healthcare system could save $9.4 billion annually through the widespread use of electronic business transactions.
“GEHA is dedicated to providing quality care and service to our members,” said Julie Browne, President and CEO of GEHA. “Conducting business transactions in the most cost-effective, accurate and timely manner is one way we ensure a high level of service, and CORE Certification demonstrates our commitment.”
APWUHP, GEHA and NALC-HBP are certified in Phases I and II of the CAQH CORE Operating Rules. APWUHP and NALC-HBP are also certified in Phase III. Each phase covers a different set of healthcare transactions or requirements.
“We proudly show the CAQH CORE seal on our website,” said Ingrid Bricker, Manager Application Development and Support of APWUHP. “Because it is an important way to display our focus on interoperability, accuracy, data security and, ultimately, member service.”
Click here for a complete list of CORE-certified organizations.
Click here to learn how to become CORE-Certified.
Learn more about the CAQH Index.
About CAQH CORE
Industry-led CAQH CORE was formed to drive the creation and adoption of healthcare operating rules that support standards, accelerate interoperability and align administrative activities among providers, payers and consumers. Today, more than 130 organizations participate in CAQH CORE, including healthcare providers, health plans representing 75 percent of insured Americans, vendors, government entities and standard setting organizations. Four phases of CAQH CORE Operating Rules have been issued to date, and CORE Certification is currently available for Phases I, II and III Operating Rules. For more information, visit www.caqhcore.org.
# # #