Comply with mandates. Simplify and save.
Operating Rules were mandated several years ago by CMS. The enforcement date is January 1, 2016, giving payers a few extra months to ensure the required service levels are above compliance thresholds. Complying with Operating Rules simplifies healthcare transactions and creates a frictionless exchange of transactions which reduces operating expense. According to an IBM survey, plans may increase the volume of insurance verifications by 33% without adding staff, once compliance with Operating Rules is in place. In its newly released 10 year roadmap, HIMSS also echoes the importance of protocols for exchanging health information.
Edifecs has closely partnered with CORE on 162 certifications (and counting) and we’ve become the most trusted Operating Rules consultants in the business. We can help get you started by performing a gap analysis and creating a project plan. Our more advanced offerings provide full support to your Operating Rules initiative. We can even help deploy our newest monitoring dashboard solution so you have constant visibility into service level agreements across your enterprise.
The Edifecs Operating Rules solution accelerates Operating Rules compliance and helps health plans monitor and maintain compliance for reporting to the Department of Health and Human Services.
Edifecs believes so strongly in administrative simplification through standardization that we built and maintain the CAQH CORE certification portal to help health plans achieve and maintain their CORE Operating Rules credential for free – 24/7/365.
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