PHILADELPHIA, PA (June 16, 2009) – InstaMed, an integrated healthcare clearinghouse and payment processor serving healthcare providers of all sizes in every state, announced today that the InstaMed Platform and Network have achieved CAQH® Committee on Operating Rules for Information Exchange (CORE®) Phase I rules certification.
As a result, providers on the InstaMed Network now have access to a significantly expanded set of consistent patient administrative information in response to electronic inquiries – data critical to initiating and completing the healthcare payment cycle.
Bill Marvin, President and CEO of InstaMed stated, “Implementing CORE accelerates InstaMed’s mission of simplifying the healthcare payment process for providers, payers and patients. We believe that CORE’s standards are an important component for improving electronic data exchange.”
A nonprofit alliance of health plans and trade associations, CAQH launched CORE to create an industry driven solution that can support all payers and enables consistent provider access to patient insurance information before or at the time of service using any electronic system. The organization has brought together more than 100 industry stakeholders, including InstaMed, to collaborate on its multi-phase set of uniform business rules to achieve that goal. CORE participants provide coverage for over 130 million lives, or more than 75 percent of the commercially insured plus Medicare and Medicaid beneficiaries.
To date, CORE has created and promulgated two phases of rules, which are built on national standards such as HIPAA. The CORE rules address data critical to the healthcare revenue cycle, including patient eligibility and benefits, patient financial liability for various service types, patient deductibles/co-pays and year-to-date patient accumulators. These rules also cover specific requirements for exchanging that information, including system connectivity, system availability, patient identification, claim status, maximum response times (batch and real-time) and the consistent use of standard acknowledgements.
Robin Thomashauer, CAQH Executive Director stated, “CORE certification demonstrates a real commitment to improving communication between providers and payers. That goal is now especially important in light of the heightened national focus on achieving a more efficient healthcare system.”
InstaMed also announced its commitment to complete the testing process for CORE’s Phase II rules in 2009.