Emdeon Commits to CAQH CORE Phase II Rules

Improving electronic administrative data exchanges

To demonstrate our commitment to improving administrative data exchanges, Emdeon has committed to complete a testing process by no later than the end of 2009 to certify that we can exchange electronic healthcare administrative data according to the CAQH Committee on Operating Rules for Information Exchange (CORE) new Phase II rules.

The voluntary business rules enhance interoperability between providers and payers; streamline eligibility, benefits and claim status transactions; and reduce the amount of time and resources providers dedicate to administrative functions. The Phase II rules cover requirements for electronic connectivity, patient identifiers, claim status and reporting of patient financial responsibility for an increased number of service codes included in the HIPAA standards. Phase II builds on the rules created by the initiative during its Phase I efforts, completed in 2006.

CAQH, a nonprofit alliance of health plans and trade associations working to streamline healthcare administration, launched CORE with the goal of enabling provider access to patient administrative information before or at the time of service using the electronic system of their choice. CORE rules are built upon existing standards, such as HIPAA. They are developed through a collaboration between more than 100 healthcare industry stakeholders as partners in a multi-phase rules development process. Participating health plans cover more than 130 million lives or more than 75 percent of the commercially insured plus Medicare and state-based Medicaid beneficiaries.

Emdeon joins more than 40 organizations that have committed to becoming Phase II rules certified or endorsing the rules.