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Aetna Endorses Effort to Simplify Transactions for Health Care Providers

Posted on: Tuesday, 3 April 2007, 12:00 CDT

Aetna (NYSE: AET) 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, 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, group life, long-term care and disability plans, and medical management capabilities. Our customers include employer groups, 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. 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.

Source: Business Wire

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