Edifecs to Certify Healthcare Organizations Participating in CAQH Eligibility and Benefits Verification Initiative
Bellevue, WA. August 16, 2006 — Edifecs, Inc., the proven leader in B2B transaction-based interoperability, today announced that it has been selected as an authorized testing vendor for the CAQH Committee on Operating Rules for Information Exchange (CORE) Phase I eligibility and benefits verification initiative. Edifecs will be responsible for certifying that healthcare organization IT systems are in compliance with the CORE Phase I rules. To demonstrate its full support of the CAQH initiative, Edifecs will provide this service at no cost to all healthcare organizations seeking CORE certification.
CAQH’s CORE Steering Committee decided to leverage Edifecs services and products to provide comprehensive healthcare transaction certification testing services for rules based on data content, connectivity, response time, acknowledgements, companion guide, and system availability.
Edifecs has become the market leader in providing healthcare EDI solutions and a partner of choice for most leading integration vendors. With over 200 customers in healthcare, and with very active and extensive participation in healthcare industry groups, Edifecs is also the dominant vendor in the market for HIPAA and other healthcare transaction testing & certification. Edifecs products help customers realize dramatic ROI by reducing friction in the transaction workflow within and between healthcare enterprises, and achieve the highest levels of transaction-based interoperability. Edifecs will employ products like Edifecs Ramp Manager community enablement solution, SpecBuilder, and XEngine transaction validation software to verify CORE Phase I rules compliance.
CAQH launched CORE in January 2005 to promote interoperability and improve provider access to eligibility and benefits information before or at the time of service using the electronic system of their choice for any patient or health plan. CORE is comprised of more than 85 industry stakeholders — health plans, providers, vendors, CMS and other government agencies, associations, regional entities, standard-setting organizations and banking industry experts. They are collaborating on a set of operating rules, modeled on those used in the banking industry to facilitate ATM banking, to
- Enhance interoperability between providers and payers
- Streamline eligibility and benefits data transactions
- Reduce the amount of time and resources providers spend on administrative functions — time better spent with patients.
CORE will address additional eligibility components and business transactions in Phase II (2006-2007) and later phases (2007-and beyond).
“Edifecs is extremely proud to have partnered with CAQH, an organization that is streamlining patient eligibility and benefits verification by building on existing standards to make electronic transactions more predictable and consistent, regardless of the technology,” said Sunny Singh, CEO of Edifecs, Inc. “We are very gratified to have been selected by the CORE team after an extensive and detailed evaluation process.”
“Edifecs proved itself to be one of the best choices in the market to complete CORE certification testing,” said Gwendolyn Lohse, project director of the CAQH initiative, “Its tools, technology and EDI-centric applications assures success for both companies.”
About CAQH
CAQH, an alliance of the nation’s leading health plans and networks working to simplify healthcare administration, is a catalyst for industry collaboration on initiatives that simplify and streamline healthcare administration. CAQH solutions help promote quality interactions between plans, providers and other stakeholders, reduce costs and frustrations associated with healthcare administration, facilitate administrative healthcare information exchange and encourage administrative and clinical data integration. Visit www.caqh.org for more information.
About Edifecs, Inc.
Edifecs helps organizations achieve interoperability and dramatic return on investment by enabling, managing and deriving business value from standard electronic transactions within trading partner communities.
Edifecs’ products include the Edifecs Healthcare Suite — a set of powerful applications and technologies that reduce friction in the administrative, clinical, financial and pharmaceutical transaction workflows, both within and between healthcare enterprises. The Suite includes business performance management applications that automate and manage the full lifecycle of transactions; from community enablement, to testing and data validation, real-time transaction monitoring, claim repair and reconciliation, facilitating direct connectivity and providing rich transaction analytics.
Edifecs provides General Industry product solutions for guideline authoring, data validation and partner enablement to manage, analyze and enforce the quality of transactional data being exchanged with a trading partner community.
2006 marks 10 years of Edifecs’ leadership and expertise in providing innovative technology solutions to over 1600 customers worldwide. Edifecs has over 200 customers and partners in healthcare that include 16 Blue Plans, 35 Medicaid, State and Federal Agencies, along with partnership arrangements with all leading middleware stack vendors. Founded in 1996, Edifecs is headquartered in Bellevue, WA. Company website: www.edifecs.com. Contact: Kevin Pierce 425-452-0622, kevinp@edifecs.com.
