CAQH Creates CORE Rules

June 24, 2011
A set of new standard business rules developed by the Washington, D.C.-based CAQH Committee on Operating Rules for Information Exchange (CORE)

A set of new standard business rules developed by the Washington, D.C.-based CAQH Committee on Operating Rules for Information Exchange (CORE) enables providers and hospitals to gain immediate access to patients' insurance information.

CAQH claims improvements were made possible by the participation of 20 leading health organizations that voluntarily exchanged patient administrative data.

According to CAQH, the voluntary industry-wide initiative has brought together nearly 100 industry stakeholders — health plans, providers, vendors, CMS and other government agencies, associations, regional entities, standard-setting organizations and other healthcare entities — to collaborate on the rules.

CAQH states that CORE's second set of rules, expected to be announced later this year, will address additional eligibility components and claims status, both of which are addressed under HIPAA.

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