CAQH CORE Education Session - Apr. 30, 2014 - Uniform Use of CARCs and RARCs Rule

CAQH CORE Education Session    CAQH CORE 360 - Uniform Use of CARCs and RARCs Rule: Insights from Industry Implementers April 30, 2014 2:00 PM - 3:30 PM ET REGISTER There is no fee to attend. Hear How National and Regional Blues Plans are Executing their Implementations Join us for a session focused on providing industry implementer tips and answering your questions about CAQH CORE 360: Uniform Use of CARCs and RARCs Rule. Updates on the CORE Code Combinations Maintenance process and status will also be shared.  Note: A working knowledge of federally mandated CAQH CORE EFT & ERA Operating Rules is assumed. Featured Panelists: Meg Barber from WellPoint Barry Hillman from Blue Cross and Blue Shield of North Carolina (BCBSNC) Erin Richter from CAQH CORE  This education session will include: Health plan-perspectives on approaches towards implementation in order to attain benefits of the CAQH CORE 360 Rule featuring: Planning, preparation and testing involved in operationalizing the Rule from BCBSNC, a CORE participating organization, CORE Phase III certified organization and Code Combinations Task Group member Best practices and tips on successfully implementing the Rule fromWellPoint, a CORE participating organization and Code Combinations Task Group member Highlights from the recent CORE Code Combinations Task Group meetings and status of Market-based and Compliance-based Reviews Information about the free implementation resources provided by CAQH CORE An in-depth Q&A session Who Should Attend All stakeholders that should currently be in compliance with the EFT & ERA operating rules and those that want to ensure they are fully benefiting from the CARCs and RARCs Rule. Register Now to Reserve Your Spot for This Free Education Session       About WellPoint WellPoint is one of the nation's leading health benefits companies. We believe that our health connects us all. So we focus on being a valued health partner and delivering quality products and services that give members access to the care they need. With nearly 68 million people served by our affiliated companies including nearly 36 million enrolled in our family of health plans, we can make a real difference to meet the needs of our diverse customers. We're an independent licensee of the Blue Cross and Blue Shield Association.    About Blue Cross and Blue Shield of North Carolina Blue Cross and Blue Shield of North Carolina (BCBSNC) is headquartered in Chapel Hill with major operations centers in Durham and Winston-Salem. BCBSNC had 3.7 million members and $58M annual net revenue in 2012. Its network of healthcare providers includes 97% of medical doctors and 99% of hospitals in North Carolina. BCBSNC provides leadership at a national level related to healthcare administrative simplification and related transactions including: CAQH and CAQH CORE Board Member and Blue Cross and Blue Shield Association.    About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

Reminder: CAQH CORE Webinar Tomorrow - Apr. 22, 2014 - Voluntary CORE Certification

REMINDER Webinar Highlighting CORE-certified Entities  Streamline Implementation of ACA-Mandated Operating Rules through Voluntary CORE Certification April 22, 2014 2:00 PM - 3:30 PM ET REGISTER There is no fee to attend.  CAQH CORE and Edifecs, along with CORE-certified entities Humana and Excellus Health Plan, invite you to this education session focused on how your organization can use Voluntary CORE Certification to demonstrate compliance with CAQH CORE EFT & ERA Operating Rules.   Take part in this session to: Learn more about Voluntary CORE Certification and how it can play a vital role in your CAQH CORE EFT & ERA Operating Rules implementation and compliance validation Receive information from CORE authorized testing vendor, Edifecs, about their CORE-authorized Operating Rule testing platform Gain valuable insights from Excellus Health Plan and Humana about: Successfully achieving Voluntary CORE Certification Benefits and advantages of CORE Certification Best practices and lessons learned for implementing the CAQH CORE EFT & ERA Operating Rules Participate in Q&A with Edifecs, Excellus Health Plan, Humana and CAQH CORE Featured panelists: Vijaya Bhuttar from Edifecs Linda Josephs from Excellus Health Plan Kim Peters from Humana Bob Bowman from CAQH CORE Who Should Attend All stakeholders interested in learning how they can plan for and test their compliance with CAQH CORE Operating Rules. This session is designed to assist representatives of health plans, clearinghouses and vendors who would like to find out more about voluntary CORE certification. Note: A working knowledge of Federally Mandated CAQH CORE EFT & ERA Operating Rules is assumed. Register Now to Reserve Your Spot for this Free Education Session About Edifecs Edifecs is the first testing vendor authorized by CORE. To date, more than 35 health plans, large provider groups and health information technology vendors have used Edifecs' Web-based CORE Certification Testing Platform to demonstrate their conformance with CAQH CORE Operating Rules. In addition to solutions that enable mandate compliance, Edifecs also offers healthcare IT solutions that foster collaboration between payers, providers and consumers to improve clinical outcomes, operations and financial performance. About Excellus Health Plan Excellus BlueCross BlueShield,a nonprofit independent licensee of the BlueCross BlueShield Association and Univera Healthcare, is part of a family of companies that finances and delivers vital health care services to about 1.8 million people across upstate New York. They provide access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools. About Humana Humana is celebrating 50 years of providing personalized and exceptional service at every level, with services to enhance the wellness of each employee no matter what stage of life. Humana's solutions range from Commercial, Individual and Medicare to Specialty Benefits and Well-being Solutions. Humana ranks 73 on Fortune 500 with 2013 revenues of $41.3 billion and total assets of approximately $20.7 billion. About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

CAQH CORE Webinar - Apr. 22, 2014 - Voluntary CORE Certification

Webinar Highlighting CORE-certified Entities  Streamline Implementation of ACA-Mandated Operating Rules through Voluntary CORE Certification April 22, 2014 2:00 PM - 3:30 PM ET REGISTER There is no fee to attend.  CAQH CORE and Edifecs, along with CORE-certified entities Humana and Excellus Health Plan, invite you to this education session focused on how your organization can use Voluntary CORE Certification to demonstrate compliance with CAQH CORE EFT & ERA Operating Rules.   Take part in this session to: Learn more about Voluntary CORE Certification and how it can play a vital role in your CAQH CORE EFT & ERA Operating Rules implementation and compliance validation Receive information from CORE authorized testing vendor, Edifecs, about their CORE-authorized Operating Rule testing platform Gain valuable insights from Excellus Health Plan and Humana about: Successfully achieving Voluntary CORE Certification Benefits and advantages of CORE Certification Best practices and lessons learned for implementing the CAQH CORE EFT & ERA Operating Rules Participate in Q&A with Edifecs, Excellus Health Plan, Humana and CAQH CORE Featured panelists: Vijaya Bhuttar from Edifecs Linda Josephs from Excellus Health Plan Kim Peters from Humana Bob Bowman from CAQH CORE Who Should Attend All stakeholders interested in learning how they can plan for and test their compliance with CAQH CORE Operating Rules. This session is designed to assist representatives of health plans, clearinghouses and vendors who would like to find out more about voluntary CORE certification. Note: A working knowledge of Federally Mandated CAQH CORE EFT & ERA Operating Rules is assumed. Register Now to Reserve Your Spot for this Free Education Session About Edifecs Edifecs is the first testing vendor authorized by CORE. To date, more than 35 health plans, large provider groups and health information technology vendors have used Edifecs' Web-based CORE Certification Testing Platform to demonstrate their conformance with CAQH CORE Operating Rules. In addition to solutions that enable mandate compliance, Edifecs also offers healthcare IT solutions that foster collaboration between payers, providers and consumers to improve clinical outcomes, operations and financial performance. About Excellus Health Plan Excellus BlueCross BlueShield,a nonprofit independent licensee of the BlueCross BlueShield Association and Univera Healthcare, is part of a family of companies that finances and delivers vital health care services to about 1.8 million people across upstate New York. They provide access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools. About Humana Humana is celebrating 50 years of providing personalized and exceptional service at every level, with services to enhance the wellness of each employee no matter what stage of life. Humana's solutions range from Commercial, Individual and Medicare to Specialty Benefits and Well-being Solutions. Humana ranks 73 on Fortune 500 with 2013 revenues of $41.3 billion and total assets of approximately $20.7 billion. About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

CAQH Video and White Paper on Coordination of Benefits

COB Smart™, a CAQH Solution is Improving Coordination of Benefits Processes Inefficient coordination of benefits (COB) processes cost the healthcare system $800 million annually. A CAQH white paper exploring the administrative inefficiencies associated with COB is now available.  The white paper examines current COB processes and summarizes common challenges, such as poor communication among public and private payers, limitations with HIPAA transaction standards and operating rules, and the number of constituents involved in complex claims practices.  A segmented cost analysis of related provider and payer expenses illustrates multiple opportunities for improving COB processes. COB Smart, a CAQH solution, is helping health plans and providers correctly identify which individuals have benefits that should be coordinated in order for corresponding claims to be processed correctly the first time. Designed for industry-wide participation, the solution is already identifying COB for more than 100 million patients. Watch the CAQH video about COB Smart to learn how the solution works and the many ways it helps health plans, providers, and individuals.   Interested in learning more or using COB Smart? Visit www.caqh.org/cob_smart.php or contact CAQH at cob@caqh.org. CAQH is a nonprofit alliance of health plans and trade associations that serves as a catalyst for industry collaboration on initiatives that simplify healthcare administration for health plans and providers, resulting in a better care experience for patients and caregivers.

CAQH CORE April Town Hall Call Featuring CMS OESS

Join Us for the CAQH CORE April Town Hall Call With Special Guest CMS OESS  A Free Information Session Open to the Public Wednesday, April 9 3:00 - 4:00 pm ET Register HERE There is no fee to attend. Join us for our April Town Hall Call to hear about: Health plan ID update from special guest CMS OESS CMS OESS will discuss key considerations regarding the Health Plan Identifier (HPID), including process to receive an HPID, educational tools, and potential uses.    CORE activities related to the HHS Certification NPRM The comment period for HHS NPRM ended on April 3.  Get an update on CORE actions in connection with the HHS NPRM. Status of industry adoption of the EFT/ERA Operating Rules The industry continues to realize the benefits of EFT/ERA Operating Rules.  Hear the latest information on the status of Operating Rule implementation. CORE Code Combination Task Group activities The CORE Code Combinations Task Group has made great progress on the compliance-based reviews and the 2013 market-based review of the CORE Code Combinations.  Get an overview and see you how you can get involved. Update on development of the third set of ACA Operating Rules CAQH CORE is working to develop the third set of Operating Rules. Learn about the CAQH CORE rule-writing process and how your organization can participate. Q&A Take part in Q&A with experts from CAQH CORE and CMS OESS. Register Now to Reserve Your Spot for this Free Education Session! CAQH CORE Town Hall Calls provide the public with an update on CORE's recent activities related to industry development and/or implementation of federally mandated operating rules. This call is open to all non-CORE and CORE Participants and is for informational purposes only; no voting or decisions will occur. If you have any questions, please contact CORE@caqh.org.

CAQH CORE Education Sessions Coming in April - Mark Your Calendar and Register Now

CAQH CORE Education Sessions: April 2014 Mark Your Calendar Join us in April for some popular topics! Registration is open! Join these webinars to hear the latest news on recent CAQH CORE activities, to learn about Voluntary CORE Certification and how you can become a CORE certified entity, and find out from guest speakers at various HIPAA covered entities how to get the benefits of implementing CAQH CORE 360: Uniform Use of CARCs and RARCs. CAQH CORE Town Hall Call Wednesday, April 9, 2014 | 3:00 - 4:00 pm ET CAQH CORE Webinar on Attachments (for CORE Participants only) Thursday, April 17, 2014 | 2:00 - 3:00 pm ET Edifecs and CAQH CORE Joint Education Session Featuring: CORE-certified entity Tuesday, April 22, 2014 | 2:00 - 3:30 pm ET CAQH CORE Education Session on the Uniform Use of CARCs and RARCs Rule Featuring: Health Plan implementers Wednesday, April 30, 2014 | 2:00 - 3:30 pm ET       ___________________________________________________________________    CAQH CORE Town Hall Call Wednesday, April 9, 2014 | 3:00 - 4:00 pm ET Register for this event HERE for free  Receive an update on recent and upcoming CAQH CORE activities by participating in our April Town Hall Call. This session will cover topics including an overview of industry adoption of the EFT/ERA Operating Rules along with status of Compliance based reviews and the results of the 2013 Market based review for CORE Code Combinations, the available tools and resources that can help you and your trading partners' implementation efforts, and an update on the Rule Development of the third set of ACA Operating Rules. _____________________________________________________________ CAQH CORE Webinar on Attachments (for CORE Participants only) Thursday, April 17, 2014 | 2:00 - 3:00 pm ET Separate registration information will be sent to CORE Participating Organizations This special session for CAQH CORE Participants will provide information about the role of attachments in the third set of Operating Rules, how different segments of the healthcare industry are utilizing attachments today and opportunities that exist for the future. CAQH CORE Participants will be asked to provide input on identified opportunities and additional opportunities for attachment Operating Rules as rule development efforts begin. For information on becoming a CAQH CORE Participant, please visit our webpage. _____________________________________________________________ Edifecs and CAQH CORE Joint Education Session Featuring: CORE-certified entity Tuesday, April 22, 2014 | 2:00 - 3:30 pm ET Register for this event HERE for free  Learn more about CORE Certification and how you can demonstrate conformance with and benefit from the ACA mandated Operating Rules by achieving CORE certification in this special joint session with CORE authorized testing vendor Edifecs. Hear from a CORE-certified entity about successfully seeking Voluntary CORE Certification, as well as advantages of CORE Certification and Operating Rule implementation in general. _____________________________________________________________ CAQH CORE Education Session on the Uniform Use of CARCs and RARCs Rule Featuring: Health Plan implementers Wednesday, April 30, 2014 | 2:00 - 3:30 pm ET Register for this event HERE for free  Join industry implementer guest speakers for this Advanced CAQH CORE education session on the Uniform Use of CARCs and RARCs Rule. This education session is focused on implementation considerations, rule requirements, the CORE Code Combinations maintenance process, and other essential information your organization needs to ensure you receive the benefits of compliance with this Rule.