CAQH CORE exists to make that happen.
We are an industry-led collaboration driving streamlined, electronic administrative data sharing. Administrative costs in the U.S. healthcare system consume nearly 15 percent of all healthcare expenditures by some estimates.
A portion of this expense is related to use of resource-intensive manual processes to conduct business transactions between providers and health plans, such as phone calls to verify patient insurance coverage or mailing claim payments. By CAQH Index estimates, the industry could save at least $9.4 billion alone by moving to electronic transactions.
To achieve this, CAQH CORE convenes providers, health plans, vendors, clearinghouses, government entities, associations and others to develop healthcare operating rules. These rules, which are backed by the government, create a common set of requirements to accelerate the adoption of electronic transactions. Operating rules like these are commonly used to conduct business across the banking and airline industries, among others.
Now is the time for healthcare to catch up.
Let's solve the problem. Become CORE-certified.
The CORE Certification program is a voluntary method for testing that enables health plans, providers, clearinghouses and vendors to demonstrate their adherence to the healthcare operating rules and underlying standards for exchanging electronic administrative data. More than 320 certifications have been awarded to date with many more in the pipeline. Learn more about what it means to become CORE-certified and how your organization can get started.