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Humana Achieves CAQH CORE Phase II Certification

Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, announced today that it has achieved The Council for Affordable Quality Healthcare (CAQH®) Committee on Operating Rules for Information Exchange (CORE®) Phase II Certification.

CAQH, a nonprofit alliance of health plans and trade associations, launched CORE to give providers consistent access to patient coverage information before or at the time of service using the electronic system of their choice for any patient or health plan, effectively reducing administrative burdens and costs.

Humana was awarded the CORE Seal after successfully completing CORE certification testing, a process that ensures that health care organizations can electronically exchange or access patient insurance information according to the CORE rules.

“The seamless sharing of data at the point of care is one way primary care providers can deliver a better health care experience to their patients,” said Brian LeClaire, Senior Vice President and Chief Service & Information Officer, Humana. “Humana’s CORE Phase II Certification reflects our commitment to enable providers, who are electronically connected to us, to provide that better experience to their patients.”

The CORE Phase II rules are advancing the way the health care industry communicates and are increasing interoperability, which will help to fulfill the priorities of the national health IT agenda. These rules, which build upon national standards, including HIPAA, make electronic administrative data communications increasingly seamless, streamlined and predictable, regardless of technology. The CORE rules are being implemented to eliminate the need for time-consuming, costly phone calls and paperwork by physicians and their office staff, freeing up time to focus on patient care.

The CORE rules were developed by over 115 participating organizations, representing providers, vendors, health plans, the Centers for Disease Control and Prevention, state and federal government agencies, associations, standard-setting organizations and other healthcare organizations.

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