Aetna Endorses Effort to Simplify Transactions for Health Care Providers.Company Adopts CAQH CAQH Coalition for Affordable Quality Healthcare Program to Standardize Electronic Information Exchange HARTFORD, Conn. -- Aetna (NYSE NYSE See: New York Stock Exchange : AET AET Aetna, Inc. AET After Extra Time AET Actual Evapotranspiration AET Alliance for Environmental Technology AET Alpha-Ethyltryptamine AET Applied Extrusion Technologies, Inc. ) has taken another step toward simplifying administrative transactions for health care providers. The company is supporting a standard set of national rules developed by the CAQH Committee on Operating Rules for Information Exchange (CORE) that promote consistent electronic information exchange among health plans and others in the health care industry. CORE operating rules build on existing standards, such as HIPAA (Health Insurance Portability & Accountability Act of 1996, Public Law 104-191) Also known as the "Kennedy-Kassebaum Act," this U.S. law protects employees' health insurance coverage when they change or lose their jobs (Title I) and provides standards for patient health, , to make electronic transactions more predictable and consistent, regardless of the technology. The CORE rules simplify the member eligibility verification process. Health care providers can submit a benefit eligibility verification request and receive a real-time response from CORE-certified health care organizations. "We are pleased to have achieved CAQH certification for CORE. It is critical that health plans continue to identify ways to reduce administration for health care providers," said Allen Karp, Aetna's vice president for health care delivery. "Aetna was a founding member of CAQH. Adopting these rules is one more way we are working with others in the industry to make business interactions for health care professionals as streamlined as possible." Aetna has been involved in CORE since the initiative's beginning. Company representatives have chaired CORE work groups and provided oversight to the rules' development. As a CORE-certified organization, Aetna has agreed to voluntarily exchange benefits eligibility information in accordance with a standard set of rules. The company completed CORE certification testing, a process that ensures Aetna's technology system and products comply with the CORE rules. CAQH launched CORE to develop a set of rules that simplify eligibility and benefits data transactions, promote better interoperability among health plans and health care providers, and improve physician access to administrative information. About Aetna Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 35.9 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health Behavioral health was first used in the 1980's to name the combination of the fields mental health and substance abuse. As an example, an organization serving both mental health and substance abuse clients might refer to its practice as behavioral health or , group life, long-term care long-term care (LTC), n the provision of medical, social, and personal care services on a recurring or continuing basis to persons with chronic physical or mental disorders. and disability plans, and medical management capabilities. Our customers include employer groups employer group Association of employers Managed care An entity with a current group benefits agreement in effect with a health plan to provide covered health care services to its employee-subscribers and eligible dependents. , individuals, college students, part-time and hourly workers, health plans and government-sponsored plans. www.aetna.com About CAQH CAQH is a catalyst for healthcare industry collaboration on initiatives that simplify and streamline healthcare administration Healthcare administration is a term that typically refers to the Master of Health Administration (MHA)—also Master of Healthcare Administration— degree, which is a graduate professional degree that provides training in health policy, economics, project and . CAQH solutions help promote quality interactions between plans, providers and other stakeholders Stakeholders All parties that have an interest, financial or otherwise, in a firm-stockholders, creditors, bondholders, employees, customers, management, the community, and the government. , 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. |
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