NCVHS Hearing on
Operating Rules
July 20 - 21, 2010:
July 20, 2010
CORE written testimony
CORE presentation
CORE oral testimony -
(Set audio track to 22:20)
July 21, 2010
CORE presentation
CORE oral presentation -
(Set audio track to 4:28:30)
CAQH follow up letter to NCVHS - 8/4/10
CORE Podcast
Listen here
(Supported by iTunes, QuickTime, Real Player)
CORE Phase II
Committed Organizations:
Are You Ready to Submit
Your Phase II Pledge?
THE PHASE II RULES
STATE ACTIVITIES
CORE State Activity and Federal HITECH Alignment
UPCOMING CORE PRESENTATIONS:
CAQH Administrative Simplification Conference
9/22/10
CORE-Certified Organizations/Products
View pending and current CORE certifications below. Only entities that use, create, or transmit eligibility or claim status data are eligible for CORE certification.
View endorser organizations by visiting the CORE Endorsers page. Organizations that do not use, create, or transmit eligibility and/or claim status data can demonstrate their support for CORE’s mission and its rules by signing the CORE Pledge, and applying for and using the CORE Endorser Seal.
Health Plans
| Organization | Certified Phase(s) (Committed Phase(s)) |
|
| Aetna, Inc. | ![]() |
Phase I Phase II |
| Anthem Colorado* | Phase I Phase II |
|
| Anthem Connecticut* | Phase I Phase II |
|
| Anthem Indiana* | Phase I Phase II |
|
| Anthem Kentucky* | Phase I Phase II |
|
| Anthem Maine* | Phase I Phase II |
|
| Anthem Nevada* | Phase I Phase II |
|
| Anthem New Hampshire* | Phase I Phase II |
|
| Anthem Ohio* | Phase I Phase II |
|
| Anthem Virginia* | Phase I Phase II |
|
| AultCare | ![]() |
Phase I Phase II |
| AvMed Health Plans | Phase I | |
| Blue Cross of California* | Phase I Phase II |
|
| Blue Cross Blue Shield of Georgia* | Phase I Phase II |
|
| Blue Cross Blue Shield of Missouri* | Phase I Phase II |
|
| Blue Cross Blue Shield of North Carolina | ![]() |
Phase I (Phase II Committed) |
| BlueCross BlueShield of Tennessee | ![]() |
Phase I Phase II |
| Blue Cross Blue Shield of Wisconsin* | Phase I Phase II |
|
| CIGNA+ | ![]() |
Phase I |
| Empire Blue Cross Blue Shield* | Phase I Phase II |
|
| Harvard Pilgrim Health Care | ![]() |
Phase I Phase II |
| HealthNet | ![]() |
Phase I (Phase II: Committed) |
| Humana** | ![]() |
Phase I (Phase II: Committed) |
| UnitedHealthcare |
(Phase I: Q4 2010) (Phase II: Q4 2010) |
|
| WellPoint | ![]() |
Phase I Phase II |
Providers
| Organization | Certified Phase(s) (Committed Phase(s)) |
|
| Mayo Clinic | ![]() |
Phase I (Phase II: Q3 2010) |
| Montefiore Medical Center | ![]() |
Phase I |
| Spectrum Laboratory Network | Phase I | |
| Summit Medical Group | ![]() |
Phase I |
| U.S. Department of Veterans Affairs | ![]() |
Phase I |
| Wake Forest University Health Sciences | Phase I |
Clearinghouses
| Organization Product |
Certified Phase(s) (Committed Phase(s)) |
|
| ACS EDI Gateway, Inc. EDI Direct - Eligibility Engine |
![]() |
Phase I Phase II |
| Availity, LLC Availity Health Information Network |
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Phase I Phase II |
| Capario (Formerly MedAvant Healthcare Solutions) Phoenix Processing System |
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Phase I Phase II |
| Emdeon Inc. Real – Time Transaction Processing and Data Hosting Services |
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Phase I Phase II |
| eServices Group Inc. Unite |
![]() |
Phase I Phase II |
| Gateway EDI RTE Individual & Integrated Transactions |
Phase I | |
| HealthFusion Healthfusion RT |
Phase I | |
| HMS HMS |
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Phase I |
| Ingenix |
(Phase I: Q3 2010) (Phase II: Q3 2010) |
|
| InstaMed InstaMed Platform and Network |
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Phase I Phase II |
| MD On-Line, Inc. ACCE$$ Patient Eligibility Verification |
![]() |
Phase I |
| MedData MedConnect |
![]() |
Phase I |
| NaviNet NaviNet |
![]() |
Phase I Phase II |
| Netwerkes, LLC Netwerkes.com Real Time Eligibility |
Phase I | |
| Office Ally Real Time Eligibility |
![]() |
Phase I |
| Passport Health Communications OneSource |
![]() |
Phase I (Phase II: Q3 2010) |
| Post-N-Track Doohickey™ Web Services |
Phase I Phase II |
|
| Practice Insight |
(Phase I: Q3 2010) | |
| RealMed Corporation RealMed Revenue Cycle Management |
Phase I | |
| RelayHealth Real Time Eligibility |
![]() |
Phase I (Phase II: Q3 2010) |
| SecureEDI/Immediata SecureEDI Clearinghouse |
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Phase I |
| Siemens/HDX Healthcare Data Exchange |
![]() |
Phase I Phase II |
| Surescripts Surescripts Prescription Benefit |
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Phase I (Phase II: Q3 2010) |
| The SSI Group, Inc ClickON E-Verify Suite |
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Phase I Phase II |
| ZirMed |
(Phase I: Q4 2010) |
Vendors
| Organization Product |
Certified Phase(s) (Committed Phase(s)) |
|
| athenahealth athenaCollector |
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Phase I Phase II |
| CSC CSC DirectConnect® |
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Phase I (Phase II: Q3 2010) |
| EmergingHealth TREKS |
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Phase I |
| eServices Group, Inc. XJ Series Gateway Services |
![]() |
Phase I Phase II |
| GE Healthcare EDI Eligibility 270/271 |
Phase I (Phase II: Q3 2010) |
|
| Health Trio, LLC |
(Phase I: Q4 2010) (Phase II: Q4 2010) |
|
| Medical Informatics Engineering WebChart EMR |
![]() |
Phase I |
| Medical Present Value, Inc. (MPV) MPV Eligibility |
![]() |
Phase I |
| NoMoreClipboard.com NoMoreClipboard.com |
![]() |
Phase I |
| Recondo Technology SurePayHealth |
![]() |
Phase I (Phase II: Q3 2010) |
| RelayHealth Payor Connectivity Services (PCS) |
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Phase I Phase II |
| RelayHealth RevRunner |
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Phase I (Phase II: Q3 2010) |
| The SSI Group Inc ClickON E-Verify Suite |
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Phase I Phase II |
| VisionShare Secure Exchange Software Interactive |
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Phase I (Phase II: Q3 2010) |
*Indicates a WellPoint company
+The following CIGNA products will be migrated to CORE certification within 12 months, with a targeted implementation of 4th quarter 2010: Great-West Healthcare (now part of CIGNA), CIGNA International Expatriate Business, CIGNA Voluntary, CIGNA Medicare Access PFFS, and limited CIGNA Medicare Advantage HMO.
** The following Humana Inc. subsidiaries will be migrated to CORE certification – Cariten (within 12 months); CarePlus Health Plans, Inc. (longer than 12 months), KMG American Corporation (longer than 12 months), Humana Benefit Plan of Illinois, Inc. (between 1/1/09 – 6/30/10). Humana Military Healthcare Services, Humana Puerto Rico, Humana Dental and CompBenefits Corporation operate out of scope of the CORE rules and are not required to use them.
















































