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Humana Announces CAQH CORE Phase III Certification

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

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

Humana has now achieved CAQH CORE Phase I, II and III Certifications.

“Humana’s certification reflects our ongoing and sustained efforts to securely exchange patient information and our commitment to similarly helping providers,” said Brian LeClaire, Senior Vice President and Chief Service and Information Officer, Humana. “As a result of electronically sharing information with providers, we help facilitate the best experience possible for our members.”

Phase III certification is the highest level an organization can achieve, and shows a commitment to reducing administrative burdens and costs. The process took four years to complete and was achieved before the national deadline for compliance of January 1, 2014.

The CORE rules have been implemented to eliminate the need for time-consuming phone calls and paperwork by physicians and their office staff, giving providers consistent access to patient coverage information. The CORE rules also advance the way health care industry leaders communicate and increase interoperability, which will help to fulfill the priorities of the national health IT agenda of building upon national standards to make electronic administrative data communications increasingly seamless, streamlined and predictable.

The CORE rules were developed by over 140 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.

By achieving the CAQH CORE Phase III certification, Humana is not only in compliance with current legislation, but also demonstrates to clinicians its commitment to provide the best service and payment model available.

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