CAQHCouncil for Affordable Quality Healthcare (Washington, DC)
CAQHCoalition for Affordable Quality Healthcare
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Robin Thomashauer, executive director of CAQH, said: "We are pleased to see UnitedHealth Group join the growing number of companies that have become CORE certified and the first to become CORE certified in a 5010 format.
The CAQH CORE EFT & ERA Operating Rules help enable accurate and efficient payment and claims processing, which saves time and money for organizations using the rules.
The Phase I and Phase II CAQH CORE Operating Rules support electronic eligibility and claim status inquiries, streamlining and bringing uniformity to these essential administrative transactions between healthcare providers and health plans.
After an extensive review of potential partners and a rigorous RFP process CAQH selected Passport to build and operate the CAQH COB solution.
The new CAQH tool will make it easier for payors to comply with this upcoming EFT mandate and reduce the burden on billing services and providers," added Dumford.
This initiative is part of our ongoing commitment to reduce costs and make administrative processes work better across the healthcare system," said Robin Thomashauer, Executive Director of CAQH.
The success of UPD demonstrates the impact that health plans, hospitals, healthcare providers, government agencies and other organizations can have when they work together to improve the efficiency of the healthcare system, and offers a promising model for future industry collaboration," said CAQH Board Chair David S.
A study conducted for CAQH by IBM Global Business Services shows that the CORE rules are helping to accelerate adoption of health information technology (HIT) and helping to provide better access to patient coverage information.
With the adoption of the CAQH CORE Phase I and Phase II operating rules related to eligibility and claim status transactions, the industry is taking an important step forward as we move to the next level of electronic solutions.
CAQH, a nonprofit alliance of health plans and trade associations, launched CORE to promote health plan-provider interoperability and improve provider access to administrative information.
A CAQH Solution(TM), COB Smart determines when an individual is covered by more than one insurer and also indicates which insurer should pay first.
of Tennessee, CDPHP, CareCentrix, MAPFRE, Midwest Health Plan, and WellPoint's affiliated Blue Cross and Blue Shield licensed health plans - are using the CAQH EFT and ERA enrollment tool to streamline how providers sign up for electronic payments.