RelayHealth Achieves CAQH CORE Phase II Certification

April 8, 2010

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 RelayHealthprovider 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 s 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.”

Sponsored Recommendations

Care Access Made Easy: A Guide to Digital Self-Service for MEDITECH Hospitals

Today’s consumers expect access to digital self-service capabilities at multiple points during their journey to accessing care. While oftentimes organizations view digital transformatio...

Going Beyond the Smart Room: Empowering Nursing & Clinical Staff with Ambient Technology, Observation, and Documentation

Discover how ambient AI technology is revolutionizing nursing workflows and empowering clinical staff at scale. Learn about how Orlando Health implemented innovative strategies...

Enabling efficiencies in patient care and healthcare operations

Labor shortages. Burnout. Gaps in access to care. The healthcare industry has rising patient, caregiver and stakeholder expectations around customer experiences, increasing the...

Findings on the Healthcare Industry’s Lag to Adopt Technologies to Improve Data Management and Patient Care

Join us for this April 30th webinar to learn about 2024's State of the Market Report: New Challenges in Health Data Management.