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CAQH Announces Humana Inc. is Certified to Use CORE Phase I Rules
Date:3/4/2009

WASHINGTON, March 4 /PRNewswire/ -- CAQH announced today that Humana Inc., one of the nation's largest health-benefits companies, has completed the testing process certifying its systems can deliver patient administrative data according to the Committee on Operating Rules for Information Exchange (CORE) Phase I rules.

Through CORE rules certification, Humana has taken another step toward more efficient exchange of patient administrative information with healthcare providers. The certification will impact approximately two-thirds of Humana's 10.6 million medical members, including Medicare beneficiaries. The CORE rules are not applicable to Humana Military Healthcare Services, and Humana's Puerto Rico operations, which together represent approximately 30 percent of Humana's total medical membership.

The announcement signifies an important milestone in the industry-driven effort to transform nationwide electronic data exchange and advance system interoperability.

CAQH launched CORE to create an all-payer solution that enables provider access to patient insurance information before or at the time of service, with providers using the electronic system of their choice. CAQH has brought together more than 100 industry stakeholders to collaborate on a multi-phase set of uniform business rules to achieve this goal.

"Humana is a founding CORE participant and is playing an essential role in shaping the CORE rules," said Robin Thomashauer, executive director of CAQH. "Its sizable presence nationally and significant Medicare membership considerably increase the impact of our administrative simplification effort."

With more than 1 million Americans covered through its Medicare Advantage plans, Humana is the second largest administrator of Medicare benefits in the U.S. Its national and regional networks include more tha
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SOURCE CAQH
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