Emdeon Achieves CAQH CORE Phase II Compliance

Anatomy of a patient-friendly bill
Emdeon has achieved compliance with the CAQH® Committee on Operating Rules for Information Exchange (CORE) Phase II rules. CAQH, a nonprofit alliance of health plans and trade associations, 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. Emdeon achieved CORE Phase I compliance in March 2007.

CORE Phase II sets industry-wide standards that improve electronic administrative information exchange between health plans and providers. Both CORE Phase I and Phase II were designed by CAQH to resolve communication disparities created by original Health Information Portability and Accountability Act (HIPAA) regulations. Persistent ambiguity in language and code sets from payer to payer has perpetuated healthcare IT inefficiencies and made adoption of electronic solutions especially challenging, labor intensive and expensive for providers that must interact with multiple payers.

As a leading provider of electronic healthcare transaction processing, Emdeon has long provided technology solutions to manage the flow of information between healthcare payers and providers and bridged the gaps caused by disparate rules for data exchange. In achieving CORE Phase II compliance, Emdeon furthers its position as an industry leader committed to healthcare efficiency and broadens its capabilities to transact information in accordance with industry standards.

"Our CORE Phase II compliance is not only good news for the thousands of providers and payers we interact with daily, it ultimately benefits patients whose care may be improved as their healthcare providers and payers can more easily exchange essential electronic information," explains Damien Creavin, chief information officer of Emdeon.

Creavin continued, "Emdeon is dedicated to reducing costs involved in the claim lifecycle and simplifying the business of healthcare— with the goal of making the system more efficient and affordable."

CAQH launched CORE to promote interoperability between healthcare payers and providers and to improve provider access to administrative information. The CORE rules are being developed by over 115 participating organizations, representing providers, vendors, health plans, the Center for Medicare and Medicaid Services, state and federal government agencies, associations, standard-setting organizations and other healthcare organizations. More than 20 leading health plans, large provider groups and technology vendors committed to completing Phase II rules certification on or before the end of March 2010. Emdeon is among these organizations.

"The CORE Phase II rules represent a transparent, consensus-based national approach to an expanded set of operating rules for electronic administrative transactions among providers, health plans and vendors," said Robin Thomashauer, CAQH executive director. "By completing CORE Phase II certification, Emdeon is making it easier for everyone to exchange real-time administrative transactions more effectively, thereby improving efficiency and freeing up time for physicians to focus on their patients."

To learn more about Emdeon, call 877.EMDEON.6 or visit us online.

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