How do the CORE Phase II rules streamline verification of patient financial responsibility?
Phase II enables providers to determine patient remaining deductibles and other patient liability for 39 service types, in addition to the nine types included in Phase I. Further, providers can electronically check the status of a claim and/or confirm payor organization receipt of the claim—with payors required to respond to claim status requests within 20 seconds. Moreover, information exchanges certified by CORE offer a safe harbor connectivity rule to facilitate interoperability across organizations; the connectivity method can be used for any administrative transaction. Providers, patients, plans and vendors all benefit from streamlined transactions that make data exchanges more efficient. Q: Why should organizations become CORE-certified? Beyond promoting interoperability and phased steps toward administrative-clinical infrastructure alignment, CORE rules decrease the amount of time and resources providers and plans spend verifying patient benefits at the point of care. Click here
