Committee on Operating Rules for Information Exchange Phase I, Phase II and Phase III
The InstaMed Network is the first to be CAQH CORE® (Committee on Operating Rules for Information Exchange) Phase II and Phase III certified! The CAQH CORE rules address data critical to the healthcare revenue cycle, and cover specific requirements for exchanging information. Phase II certification allows InstaMed 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. The Phase II rules build on the Phase I rules, with additional rules for patient identifiers, patient accumulators, claims status and connectivity. The Phase III rules define standards for payers to deliver ERA (electronic remittance advice) and EFT (electronic funds transfer) to their providers. A key part of this mandate is the requirement to enable providers to re-associate the ERA with the EFT using the EFT trace number, which simplifies provider posting and reconciliation of payer payments.