Certification demonstrates commitment to interoperability and health plan partners
ATLANTA, April 7, 2010 - RelayHealth, a leading provider of healthcare connectivity services, announced today that its Payor Connectivity Services (PCS) has recently earned certification from the CAQH® Committee on Operating Rules for Information Exchange (CORE®) Phase II. The CORE Seal was awarded after RelayHealth successfully completed CORE certification testing - a process ensuring that healthcare organizations can electronically exchange or access patient insurance information according to the CORE standards.
CORE certification means that RelayHealth provider customers can securely process electronic queries within 20 seconds and receive consistent patient administrative information according to the CORE standards. CAQH, a non-profit alliance of health plans and trade associations, launched CORE to promote health plan - provider interoperability and improve provider access to administrative information.
“RelayHealth is an established connectivity leader, and we applaud CAQH’s leadership in driving health information exchange improvements,” said Jim Bodenbender, president of RelayHealth Connectivity Solutions. “We consider CORE Phase II certification a significant accomplishment in advancing interoperability of our Payor Connectivity Services. Our goal is to help critical HIE stakeholders like healthcare providers and payors conduct business more efficiently through real-time financial, administrative and clinical information exchange.”
RelayHealth’s Payor Connectivity Services is a HIPAA-compliant electronic gateway which allows health plans to better manage their HIPAA transactions, offers real-time eligibility and claims status checks, performs validation and editing on pre-adjudicated claims, and communicates with providers on potential issues.
More than 20 health plans, large provider groups and technology vendors have committed to completing Phase II certification, which is expected to yield both process efficiencies and cost savings. 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. An industry-wide adoption of the CORE Phase I rules could save the industry an estimated $3 billion over three years. Widespread adoption of the Phase II rules and subsequent phases of CORE are expected to result in even higher savings for stakeholders across the industry.
Bodenbender noted RelayHealth’s PCS is among the first companies to achieve CORE Phase II Vendor Certification. “CORE’s process was rigorous,” he said. “We put in six weeks of dedicated effort to achieve CORE Phase II certification, in addition to helping a key customer adopt the CORE Phase II rules.”
About RelayHealth
RelayHealth, McKesson’s connectivity business, operates as a neutral partner in an open network environment, offering connectivity services and integration among all organizations, systems, and solutions. Its intelligent network is designed to streamline clinical, financial and administrative communication between patients, providers, payors, pharmacies, pharmaceutical manufacturers, and financial institutions. RelayHealth works to accelerate the delivery of high-quality care and improve financial performance through solutions such as online consultation of physicians by patients, electronic prescribing, point-of-service pharmacy claims resolution by payors, pre-visit patient financial clearance by providers, and post-visit provider bill settlement by payors and patients. RelayHealth securely processes more than 12.8 billion financial and clinical transactions annually. For more information, call (800) 778-6711, or visit our Web site at www.RelayHealth.com.
About the Committee on Operating Rules for Information Exchange (CORE)
CAQH launched CORE, a multi-phase, collaborative healthcare industry initiative five years ago. CORE is focused on improving provider access to electronic patient administrative and payer information before or at the time of service, using any technology. The CORE rules build upon national standards, such as HIPAA. Each phase expands the available data criteria and augments the functional requirements for electronic data exchange.
CAQH has convened more than 115 healthcare industry stakeholders as participants in developing the CORE rules. Participating health plans cover more than 130 million lives or approximately 75 percent of the commercially insured, Medicare and state-based Medicaid membership. View www.caqh.org/CORE_overview.php for more information.
CORE®, the CORE-certification/Endorser Seals and logo are registered trademarks of CAQH®Copyright 2010, Council For Affordable Quality Healthcare®. All rights reserved.
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