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InstaMed Achieves Core Phase II Certification to Streamline Provider Access to Consistent Electronic Eligibility and Claim Status

Tuesday, December 22, 2009 News on IT in Healthcare J E 4
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PHILADELPHIA, Dec. 22 -- InstaMed, the industry leading healthcare payments network and platform, announced today that it has achieved CAQH® Committee on Operating Rules for Information Exchange (CORE®) Phase II rules certification for its InstaMed Platform and Network product. 

The InstaMed Platform and Network product achieved CORE Phase I certification in June of this year.  Phase II certification allows the company to deliver increased access to a significantly expanded set of consistent patient administrative information in response to electronic inquiries, such as real-time eligibility and claim status.  This data is critical to initiating and completing the healthcare payment cycle.

Bill Marvin, President and CEO of InstaMed stated, "CORE Phase II certification solidifies our commitment to improving electronic data exchange.  This accomplishment demonstrates our innovation and leadership, as we are one of the first clearinghouses to achieve this level of certification." 

A nonprofit alliance of health plans and trade associations, CAQH launched CORE to create an industry driven solution that supports all payers and enables consistent provider access to patient insurance information before or at the time of service using any electronic system.  The organization has brought together more than 100 industry stakeholders, including InstaMed, to collaborate on its multi-phase set of uniform business rules to achieve that goal.  CORE participants provide coverage for over 130 million lives, or more than 75 percent of the commercially insured plus Medicare and Medicaid beneficiaries.

To date, CORE has created and promulgated two phases of rules, which are built on national standards such as HIPAA.  The CORE rules address data critical to the healthcare revenue cycle, including patient eligibility and benefits, patient financial liability for various service types, patient deductibles/co-pays and patient accumulators. These rules also cover specific requirements for exchanging that information, including system connectivity, system availability, patient identification, claim status, maximum response times (batch and real-time) and the consistent use of standard acknowledgements.

Robin Thomashauer, CAQH Executive Director stated, "By achieving CORE Phase II certification, InstaMed is demonstrating its leadership role in simplifying healthcare administrative transactions.  This accomplishment shows a true commitment to improving communication between providers and payers, which directly and favorably impacts the industry."  

About InstaMed

InstaMed is the industry leading healthcare payments network and platform. InstaMed's mission is to transform the healthcare payment process for healthcare Providers, Payers and Patients so their payment experience is simple, convenient, reliable and secure. InstaMed processes all of the healthcare and payment transactions in the healthcare revenue cycle and offers patent pending, integrated healthcare and payment transactions that accelerate the healthcare payment process and reduce the administrative costs to all parties. Through its channel partner relationships, InstaMed currently supports the healthcare payment processing needs of over 2,000 hospital and clinic locations; practice management vendors and billing services representing over 100,000 providers; and hundreds of healthcare payers of all sizes. InstaMed is registered with Visa and MasterCard and is certified as a Payment Card Industry Data Security Standards (PCI-DSS) Level One Service Provider. InstaMed is also fully accredited by the Electronic Healthcare Network Accreditation Commission (EHNAC) as a healthcare clearinghouse. InstaMed is an AHIP Solutions Partner (America's Health Insurance Plans), a certified member of CORE (the CAQH Committee on Operating Rules for Information Exchange), the Medical Banking Project, ASC X12, HBMA (Healthcare Billing & Management Association), Electronic Payments Network ACH Association Services, MGMA's Project SwipeIT (Medical Group Management Association) and WEDI (Workgroup for Electronic Data Interchange). Visit InstaMed on the web at www.instamed.com.

SOURCE InstaMed

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