ATLANTA--(BUSINESS WIRE)--Today McKesson Payer Connectivity ServicesTM, a HIPAA-enabled EDI gateway for health plans, announced it has earned a CAQH® Committee on Operating Rules for Information Exchange (CORE®) Vendor Phase III Certification Seal. This certification furthers efficiency in healthcare by helping health plans stay compliant with federal regulations while maintaining communication with providers, which is critical to successful care and payment coordination. McKesson is one of only 15 organizations across America to achieve CORE III certification.
“McKesson is once again at the forefront of healthcare industry technology standards,” said Carolyn Wukitch, SVP and general manager of Network and Financial Management at McKesson Health Solutions. “The CORE III certification process was rigorous, and required more than six months of dedicated planning, development and testing. It’s another example of our ongoing investment in healthcare IT that helps the industry move from fee-for-service to value-based care models.”
The CORE III Certification Seal was awarded after McKesson Payer Connectivity Services (PCS) successfully completed CAQH’s certification testing, a process that ensures an organization can electronically exchange or access patient insurance information according to the CORE Phase III rules. The process also ensures that the organization has previously achieved CORE Phase I and II certifications, and has demonstrated its ability to meet the requirements of the Affordable Care Act’s Operating Rules governing electronic remittance advice (ERA) and electronic funds transfer (EFT).
More than 100 health plans, provider groups, and technology vendors have completed at least one phase of CORE certification, and 15—including McKesson PCS—have gone on to achieve CORE III Certification. As it did for prior CORE phase certifications, McKesson partnered with customer AultCare, which also achieved CORE III certification for its health plan.
McKesson PCS is a HIPAA-compliant electronic data interchange (EDI) gateway, which allows health plans to better manage their HIPAA transactions, offers real-time claims, eligibility and claims status checks, performs validation and editing on pre-adjudicated claims, and communicates with providers on claims issues.
“Our vision is for all healthcare providers, payers and supporting parties to be able to connect, interoperate and do business in a way that promotes increased safety, quality and efficiency,” Wukitch said. “CORE certification is an important way to support and advance that vision.”
CAQH, a nonprofit alliance of more than 100 health plans and trade associations, launched CORE to promote health plan-provider interoperability and improve provider access to administrative information. These stakeholders cover more than 130 million lives, or more than 75 percent of the commercially insured plus Medicare and state-based Medicaid beneficiaries.
For more information on McKesson Health Solutions, please visit our website, hear from our experts at MHSdialogue, and follow us on Twitter at @McKesson_MHS.
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About CAQH
CAQH 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 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 McKesson Corporation
McKesson Corporation, currently
ranked 15th on the FORTUNE 500, is a healthcare services and information
technology company dedicated to making the business of healthcare run
better. McKesson partners with payers, hospitals, physician offices,
pharmacies, pharmaceutical companies and others across the spectrum of
care to build healthier organizations that deliver better care to
patients in every setting. McKesson helps its customers improve their
financial, operational, and clinical performance with solutions that
include pharmaceutical and medical-surgical supply management,
healthcare information technology, and business and clinical services.
For more information, visit www.mckesson.com.
