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NAVINET IS THE FIRST VENDOR TO ACHIEVE CAQH CORE PHASE II CERTIFICATION FOR CONSISTENT HEALTHCARE ADMINISTRATIVE DATA EXCHANGE
CAMBRIDGE, Mass. - 5/18/09–
NaviNet (formerly NaviMedix), America’s largest real-time healthcare communications network, announced that it is the first vendor to receive a CAQH® Committee on Operating Rules for Information Exchange (CORE®) Phase II clearinghouse product Certification Seal. The CORE Seal was awarded after NaviNet successfully completed certification testing – a process ensuring that healthcare organizations can electronically exchange or access patient insurance information according to the CORE Phase II rules.
CORE Phase II rules expand upon the data consistency and interoperability improvements gained by rules created in CORE Phase I. The Phase II rules cover requirements for electronic connectivity, patient identifiers, claims status, and reporting of year-to-date patient financial responsibility and coverage, including an increased number of service type codes that are defined by HIPAA.
NaviNet connects more than 730,000 enrolled healthcare providers, 20+ health plan customers and numerous industry partners through a single, secure Web portal to conduct real-time financial, clinical and administrative communications. Through NaviNet, providers have immediate access to patient information such as eligibility, benefits and claim status, as well as advanced clinical information, including patient care alerts and personal health records, from health plans and other companies who sponsor and support providers’ participation in the NaviNet Provider Network.
“Efficient and secure information exchange is critical to delivering high-quality, cost-effective healthcare,” said Brad Waugh, president and CEO of NaviNet. “Being the first vendor to receive CAQH CORE Phase II certification reinforces NaviNet’s commitment to fostering collaboration in healthcare, a fundamental principle of national health information exchange.”
The CORE rules, which build upon national standards, including HIPAA’s eligibility (X12 270/271 and 276/277) transaction, make electronic administrative data communications seamless, streamlined and predictable, regardless of the technology. In many cases, the CORE rules eliminate the need for time-consuming phone calls and paperwork.
“The CORE rules represent a cutting-edge approach to streamlining electronic administrative data exchange,” said Robin J. Thomashauer, CAQH executive director. “By adopting the rules and completing CORE-certification, NaviNet is reducing unnecessary healthcare administrative burden, and helping U.S. healthcare become more efficient and responsive to patient concerns.”
CAQH is 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 and its members are working to achieve a healthcare system in which administrative processes are efficient, predictable, and easily understood by patients, caregivers and providers. In this system, administrative and clinical data are integrated to effectively support the delivery of care. Visit www.caqh.org for more information.
NaviNet (formerly NaviMedix) is America’s largest real-time healthcare communications network, securely linking over 700,000 providers and the nation’s patients, industry partners and leading health plans. NaviNet’s advanced solutions, services and expertise streamline business processes and drive industry-leading innovation. In a time when access to healthcare is a critical issue, NaviNet fosters collaboration and helps government, plans and providers improve quality of care and reduce costs. For more information, or to sign up for NaviNet, please visit www.NaviNet.net or call 617-715-6000 or 800-805-7569.
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