CAQH Press Releases | Affordable Quality Health Care Press | News

National Plans Improve Provider Access to Consistent Electronic Eligibility, Benefits and Claims Data for 50 Million Members​

WASHINGTON, DC - 12/28/09

CAQH® announced today that Aetna and WellPoint, together serving over 50 million members, are the first national health plans to earn certification for electronically exchanging administrative data using the CAQH Committee on Operating Rules for Information Exchange® (CORE) Phase II rules.

Thirteen New Entities Working with Over a Million Providers Join in Helping Develop Rules that Streamline Electronic Administrative Data Exchange


CAQH® announced today that its Committee on Operating Rules for Information Exchange® (CORE) initiative is advancing its goal to provide an electronic data exchange solution that can support all payers, public and private alike. CAQH has awarded CORE-certification to the first vendor solely focused on offering Medicaid services. Moreover, CAQH has achieved increased support from twelve other organizations since April.


In its September 2009 Final Report and Recommendations to Develop a Standardized Electronic Identification System for Health Insurance, a Colorado Work Group has recommended that the Commissioner of Insurance require the uniform use of the CAQH® Committee on Operating Rules for Information Exchange® (CORE) rules. The CORE rules are proposed for use by payers, providers, and vendors to improve interoperability and streamline the exchange of administrative healthcare information.

Twenty Organizations Sign On to CAQH UPD Service in Second Quarter

WASHINGTON, DC - 7/30/09

CAQH® announced today that an additional 20 organizations are eliminating redundant processes and streamlining provider data collection through its Universal Provider Datasource® (UPD) online service.

Industry-wide Implementation Could Yield $3 Billion of Savings in Three Years


CAQH® announced today that a study of results achieved by health care providers and health plans that are certified to use the Phase I rules of its Committee on Operating Rules for Information Exchange® (CORE) showed dramatic cost savings, accelerated use of real-time electronic transactions, improved claims verifications and reduced claims denials.

WASHINGTON, DC - 5/28/09

CAQH® and the Electronic Healthcare Network Accreditation Commission (EHNAC) announced today that they have formed a partnership to promote electronic health data exchange through, and industry best practices for, clearinghouses.

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.

Interest in Administrative Simplification Grows Under Healthcare Reform Efforts

WASHINGTON, DC - 4/27/09

CAQH® announced today that an additional 10 leading healthcare organizations have recently joined or increased their participation in its Committee on Operating Rules for Information Exchange® (CORE) initiative, a national collaboration that is advancing electronic connectivity and administrative data exchange.

Health Plan Rules Certification Adds to CAQH Initiative Momentum


CAQH announced today that Harvard Pilgrim Health Care, Inc. (Harvard Pilgrim), a health plan serving one million members throughout New England, completed the testing process certifying its systems can exchange administrative data according to its Committee on Operating Rules for Information Exchange® (CORE) Phase I and Phase II rules.

Industry Initiative Sets Sights on Streamlining Directories, Claims Processing

WASHINGTON, DC - 3/31/09

CAQH announced today that more than 700,000 physicians and allied healthcare professionals are now reducing duplicative paperwork and administrative costs by using its nationwide, online Universal Provider Datasource® (UPD) service to submit and maintain information required for credentialing and other provider data-driven processes.