CORE Statements of Support

"CORE’s work to simplify access to critical patient administrative information complements similar efforts in the clinical arena. The Phase II rules are an important step forward in facilitating system interoperability and achieving integrated patient data exchange."

- H. Stephen Lieber, CAE
President and CEO
HIMSS

"BCBSA is pleased to participate in CAQH CORE's efforts to streamline electronic eligibility. Simplifying provider access to patient insurance coverage information is critical and the Blues believe that CORE is a key initiative to bring the industry together for collaboration and consensus building."

- Blue Cross and Blue Shield Association

"ASC X12 applauds CAQH progress on health care insurance eligibility inquiry and response interoperability. The ASC X12N implementation guides for this purpose, the 270/271 version 004010A1, while mandated by the HIPAA legislation for eligibility exchanges, do not mandate required benefit coverage explanations. Implementations of the eligibility transactions have produced different levels of information from a minimum of information to a full explanation of all covered benefits. In many cases the information given was not sufficient for the business requirements of the providers. This requires the providers to make additional inquiries to obtain the needed information for proper administration of patient care and billing processes. Additionally, eligibility transaction implementations have produced different flavors of companion guides which demonstrate the different levels of responses to eligibility inquiries.

CAQH’s efforts to build industry consensus on what data the providers really need from an eligibility transaction to effectively provide patient care and receive payment for those services is admirable. CAQH and ASC X12 share the goal of effective, efficient EDI interoperability that promotes integration and reduces human interaction. Standardization is an iterative process and ASC X12 appreciates the help of those in the community who drive toward this goal using the ANSI cross-industry standards."

- ASC X12

"CORE is nothing short of groundbreaking. The initiative is helping to define the future of electronic communication between health plans and providers by bringing together industry stakeholders to develop standard rules that promote interoperability and significantly simplify provider access to critical patient insurance coverage."

- Bob Greczyn
CEO and President
Blue Cross and Blue Shield of North Carolina