Many insurers, provider organizations and IT vendors have agreed to utilize industry-developed rules to standardize HIPAA eligibility verification and benefits determination transactions, Health Data Management reports.
Payer advocacy group CAQH through its Committee on Operating Rules for Information Exchange headed the effort to standardize the HIPAA transactions, beginning with eligibility and benefit determination, Health Data Management reports.
Insurers that have pledged to support by March 31, 2007, a new eligibility and benefit determination standard include:
- Aetna;
- AultCare;
- Blue Cross Blue Shield of North Carolina;
- Health Net;
- Health Plan of Michigan;
- Humana; and
- WellPoint and its 14 Blues subsidiaries.
Some of the committed vendors and clearinghouses include Emdeon, McKesson Provider Technologies and MedAvant Healthcare Solutions. The Mayo Clinic and Montefiore Medical Center in New York also have agreed to use CORE standards to conduct eligibility and benefit determination transactions by March 31, 2007 (
Health Data Management, 9/14).