Achieving Healthcare Interoperability Through Voluntary CORE Certification and Testing – A Joint CAQH / Edifecs Webinar

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Explore How Operating Rules are Simplifying Healthcare Administration for Providers and their Practice Management System Vendors

All stakeholders participating in the chain of healthcare administrative data exchange can help advance interoperability between providers and health plans. Testing to ensure they handle administrative data in accordance with the CAQH CORE Operating Rules is an ideal step. To date, nearly 60 organizations have voluntarily completed CORE Certification and Testing through a CAQH CORE-authorized testing entity. By completing the voluntary CORE Certification process, organizations that create, transmit and/or use eligibility and claim status data, demonstrate their ability to handle administrative data in accordance with the CAQH CORE Operating Rules.

It is extremely important that trading partners maximize the benefits of implementing operating rules by focusing on the role of the clearinghouse and its relationship with health plans and/or providers.

In this complimentary webinar, regulatory compliance expert Debbie McCachern will explain how voluntary CORE Certification requirements for clearinghouses and health plans vary, depending on how they interact with each other and which services they provide. The webinar will also include a live demonstration of the CORE-authorized testing platform from Edifecs.

WHEN: Wednesday, November 30, 2011 at 11:00AM PST / 2:00PM EST.

WHAT: A webinar that will discuss how voluntary CORE Certification requirements differ for clearinghouses and health plans, depending on how they work with each other and which services they offer. Attendees will:

  • Learn about the CAQH CORE Operating Rules phased development process and timeline for adoption of federally mandated operating rules
  • Understand how a successful voluntary CORE Certification encourages trading partners to work together on data flow and content needs
  • Learn about the variety of ways that clearinghouses support both health plans and providers in achieving their goal of implementing CAQH CORE Phase I and Phase II Operating Rules for eligibility and health care claim status transactions
  • Observe a live demonstration of the Edifecs testing platform and identify necessary steps in the successful completion of conformance testing


About Edifecs, Inc.
An industry leader since 1996, Edifecs provides healthcare software solutions that improve operational performance by streamlining the exchange of information between health plans, hospitals, and other healthcare organizations, while enabling compliance with current mandates such as HIPAA 5010 and ICD-10.

Today, more than 250 healthcare customers use Edifecs technology to unify transactions from any information channel source and input mechanism, while automating manual business processes such as enrollment, claims and payments management.

Edifecs is currently recognized as one of the 100 Fastest Growing Private Companies in the state of Washington, 100 Best Places to Work for in the state of Washington, an Inc. 5000 fastest-growing private company and one of the 500 Fastest Growing Companies in North America by Deloitte. Edifecs is headquartered in Bellevue, WA. For more information, please visit

About CORE
CORE, an initiative of CAQH, is a multi-stakeholder collaboration that is developing and driving adoption of voluntary national operating rules that help streamline electronic healthcare administrative data exchange. Since its inception, CORE has grown to nearly 130 participating organizations that represent all aspects of the industry. Participants include health plans which maintain eligibility and benefits data for over 150 million lives, or approximately 75% of the commercially insured plus Medicare and state-based Medicaid beneficiaries. Many of these participant organizations have implemented the CAQH CORE Phase I and II Operating Rules, successfully completed stakeholder-specific testing, and received a CORE Certification Seal. Today CORE-certified health plans cover more than 120 million commercially insured lives across the U.S.


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Robin Rees
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