Gateway EDI Achieves CAQH CORE Phase I Certification for Consistent Health Care Administrative Data Exchange

Sept. 23, 2009

St. Louis, MO  (April 15, 2010) – Gateway EDI, one of the nation’s fastest growing health care electronic data interchange (EDI) providers, today announced that its RTE Individual & Integrated Transactions product has received

a CAQH® Committee on Operating Rules for Information Exchange (CORE®) Phase I Clearinghouse Certification Seal. The CORE Seal was awarded after Gateway EDI successfully completed certification testing for its clearinghouse product – a process ensuring that health care organizations can electronically exchange or access patient insurance information according to the CORE Phase I rules.

CORE-certification ensures that Gateway EDI customers can securely process electronic queries within 20 seconds and that providers will receive consistent patient administrative information.

“We are proud to have achieved the CORE Phase I Seal because of the significant benefits it offers our customers,” said Charlotte A. Martin, Gateway EDI’s president and chief operating officer. “This certification ensures that processes are in place to help our health care providers achieve dramatic cost savings, fewer claim denials and improved functions. We are pleased to be affiliated with CAQH because they work to simplify processes and reduce administrative burden.”

Martin continued, “Gateway EDI offers real-time and batch solutions for patient eligibility. The CORE certification will also ensure that we are processing these transactions as efficiently as we can. We are looking forward to more and more payers adopting the same rules to enhance and streamline the information we can route to the provider. This greatly enhances the value of these transactions.”

The CORE rules, which build upon national standards, including HIPAA’s eligibility (X12 270/271) transaction, make electronic administrative data communications seamless, streamlined and predictable, regardless of the technology. In many cases, the CORE rules eliminate the need for time-consuming phone calls and paperwork.

A recent study found that when trading partners exchange administrative data according to the CORE rules, the organizations reduce costs and streamline administrative processes. The CAQH study conducted by IBM Global Business Services shows that the CORE rules are accelerating adoption of HIT technology and helping to provide better access to patient coverage information. An industry-wide adoption of the CORE Phase I rules alone could save the industry an estimated $3 billion in three years.

“The CORE rules represent a cutting-edge approach to streamlining electronic administrative data exchange,” said Robin J. Thomashauer, CAQH executive director. “By adopting the rules and completing CORE-certification, Gateway EDI is reducing unnecessary health care administrative burden, and helping U.S. health care become more efficient and responsive to patient concerns.”

September 2009

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