RealMed’s Achieves CAQH CORE™ Certification for Consistent Healthcare
Administrative Data Exchange
INDIANAPOLIS, November 6, 2008 -- RealMed, a leader in web-based, medical provider revenue cycle
management software solutions and services, announced today that it has received a CAQH Committee
on Operating Rules for Information Exchange (CORE™) Phase I Certification Seal. The CORE Seal was
awarded after RealMed successfully completed certification testing – a process ensuring that healthcare
organizations can electronically exchange or access patient insurance information according to the CORE
Phase I rules.
CORE certification ensures that RealMed users can securely process electronic eligibility queries within
20 seconds and that providers will receive consistent patient administrative information.
The CORE rules, which build upon national standards, including HIPAA’s eligibility (X12 270/271)
transaction, make electronic administrative data communications seamless, streamlined and predictable,
regardless of the technology. In many cases, the CORE rules eliminate the need for time-consuming
phone calls and paperwork.
According to a recent CAQH study, providers may reduce labor costs associated with verifying insurance
coverage as much as 50 percent by moving from labor-intensive verification methods (Web, fax and
phone) to automated HIPAA transactions. Health plans also could achieve significant labor savings, as
the study showed that average labor costs per phone call are $1.38 vs. $0.00 for an automated
transaction.
CAQH, a nonprofit alliance of health plans and trade associations, launched CORE to promote health
plan-provider interoperability and improve provider access to administrative information. To date, the
voluntary industry-wide initiative has brought together more than 100 healthcare industry stakeholders –
health plans, providers, vendors, CMS and other government agencies, associations, regional entities,
standard-setting organizations and banking industry experts – to develop the operating rules. These
stakeholders cover more than 130 million lives, or more than 75 percent of the commercially insured plus
Medicare and state-based Medicaid beneficiaries.
“The CORE rules represent a cutting-edge approach to streamlining electronic administrative data
exchange," said Robin J. Thomashauer, CAQH executive director. "By adopting the rules and completing
CORE certification, RealMed is reducing unnecessary healthcare administrative burden, and helping U.S.
healthcare become more efficient and responsive to patient concerns.”
About RealMed
RealMed helps today's healthcare organizations by optimizing information exchange through dynamic revenue cycle, clinical and financial management solutions. We take a unique approach to client service, partnering with 23,000 physicians through our highly-rated local support teams. RealMed empowers healthcare organizations to minimize transaction processing costs, increase user productivity and reduce the administrative burden placed on all stakeholders. RealMed solutions support real-time and batch information exchange via a web portal, electronic data interchange (EDI) and business to business (B2B) integrations. RealMed has electronic access to over 2,000 payers. For more information, please visit www.realmed.com.
About CAQH
CAQH is a catalyst for industry collaboration on initiatives that simplify healthcare administration for health
plans and providers, resulting in a better care experience for patients and caregivers. CAQH and its
members are working to achieve a healthcare system in which administrative processes are efficient,
predictable, and easily understood by patients, caregivers and providers. In this system, administrative
and clinical data are integrated to effectively support the delivery of care. Visit
www.caqh.com for more
information.