Availity earns CAQH CORE Clearinghouse Product Phase III Certification Seal


Availity, the nation’s largest real-time health information network, announced that it earned a CAQH® Committee on Operating Rules for Information Exchange (CORE®) Clearinghouse Product Phase III Certification Seal. This certification includes Availity’s wholly owned subsidiaries RealMed and HeW.

CAQH 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 burden and costs.

The CORE Seal was awarded after Availity successfully completed voluntary CORE Certification testing well ahead of the January 1, 2016, certification deadline, ensuring it can exchange healthcare Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) information in conformance with the Phase III CAQH CORE EFT ERA Operating Rules and Policies. The CORE Seal also ensures that Availity completed certification of Phase I and Phase II, demonstrating the company’s ability to meet the requirements of the Affordable Care Act’s Operating Rules governing ERA and EFT.

As the nation’s largest real-time health information network, Availity’s network extends to more than 900,000 active providers, 2,700 hospitals, 675 vendor partners and all health plans nationwide. Since 2001, Availity has proven to be a trusted intermediary for information exchange between health plans and providers, easing the complexity of moving business and clinical information to health care stakeholders nationwide. Real-time, point-to-point connectivity provides speed and accuracy at the intersection of health care and technology.

“The CAQH CORE Clearinghouse Product Phase III Certification Seal demonstrates Availity’s commitment to the highest standards of electronic transaction processing,” said Russ Thomas, CEO of Availity. “By achieving certification well ahead of the January 1 deadline, we are demonstrating to our customers that we are going to allow them to be CORE compliant sooner.”

Under the Affordable Care Act (ACA), healthcare operating rules are required for HIPAA claims-related electronic transactions as part of the federal vision for health data interoperability. CAQH CORE was named by the Secretary of Health Human Services (HHS) as the authoring entity of these operating rules. CAQH CORE certification verifies that an organization or product operates in agreement with the operating rules and the underlying standards, and is doing so with their trading partners as well.

“We have a commitment as an organization to meet the letter of the law, as well as the spirit of the law,” Thomas said. “By achieving this certification, Availity is publicly demonstrating a commitment to operate in accordance with the operating rules and simplify electronic healthcare transactions.”

Availity