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Life Health > Health Insurance > Your Practice

Aetna To Insist On CORE Standards Certification

By Staff Writer

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A large health insurer is backing efforts by the Council for Affordable Quality Health Care to create new benefits eligibility data exchange standards.

Aetna Inc., Hartford, says it will require all of its administrative data-exchange vendors to show that they comply with the Committee on Operating Rules for Information Exchange administrative information standards.

CAQH, Washington, created the CORE program in an effort to streamline the process of getting and providing administrative information about health plan members.

Ronald Williams, the chairman of CAQH, also is the chairman of Aetna, and CAQH has certified that a total of 25 health care organizations and products comply with the CORE Phase I standards, CAQH says.

A portion of the CORE standards, the CORE Phase I rules, are part of a broader set of “consumer empowerment” standards developed by the Healthcare Information Technology Standards Panel, Chicago.

In January, the U.S. Department of Health and Human Services recognized the HITSP consumer empowerment standards, including the CORE Phase I standards, as standards that can be used in federal health programs, according to CAQH.

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