Momentum for the initiative is growing, as evidenced by regional and state support of the CORE rules. Multi-stakeholder groups in Ohio, Texas, Colorado and Virginia have recommended the CORE rules for statewide implementation.
"By using the CORE rules, WellPoint is further promoting the use of electronic data exchange so members and physicians have access to the necessary information to make the best healthcare decisions," said Angela Braly, president and CEO, WellPoint, Inc. "Through initiatives like this, which take advantage of lessons learned by other industries, the healthcare industry is working together to find innovative solutions to drive down costs and improve the quality of care for Americans."
The CORE rules are developed by over 115 participating organizations, representing providers, vendors, health plans, CMS and other government agencies, associations, regional entities, standard-setting organizations and other healthcare entities. More than 20 leading health plans, large provider groups and technology vendors are committed to completing Phase II certification in the coming months. CORE participants are currently developing the Phase III rules, which build on Phase I and Phase II. The third set of rules focuses on improving the electronic exchange of additional administrative transactions, such as prior authorization and remittance advice. The CORE rules actively support critical privacy and security practices, including HIPAA.
"The CORE Phase II rules represent a significant milestone in using transparent, consensus-based, national operating rules to streamline electronic administrative transactions among providers, health plans and vendors," said Doug Henley, M.D., FAAFP, executive vice president and CEO of the American Academy of Family Physicians. "Health plans that complete CORE Phase II certificatio
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