WASHINGTON – The Council for Affordable Quality Healthcare and Bellevue, Wash.-based Edifecs have launched an updated online platform for certifying conformance with the Committee on Operating Rules for Information Exchange (CORE) operating rules.

Edifecs, a CORE-authorized testing vendor, is providing the updated testing platform which supports the HIPAA 5010 transactions and associated errata.

[See also: CAQH makes new recommendations for CORE governance.]

The CORE operating rules build upon and work in unison with industry standards to streamline administrative exchanges. The rules are updated whenever federal or state regulations mandate a change to an underlying standard. The original set of CORE operating rules and related test suites were developed based on HIPAA 4010 transactions.

Effective January 1, 2012, HIPAA-covered entities will be required by federal regulation to comply with HIPAA 5010 transactions and associated errata. Some of the CORE v4010 operating rules requirements have been incorporated into HIPAA 5010 and are therefore not included in the updated CORE v5010 operating rules. The CORE website includes a Summary of v5010 Updates detailing the changes.

CORE certification is voluntary and achieved by organizations that can demonstrate their systems operate in accordance with the CORE operating rules, which improve provider access to patient benefits coverage and financial information at the point-of-care.

With the launch of the updated testing platform, Edifecs has applied the CORE operating rule updates that reflect HIPAA 5010 requirements. Healthcare entities and their vendors pursuing CORE certification now have the option of accessing a free online testing service for either HIPAA 4010 or 5010.

[See also: Top 5 HIPAA 5010, ICD-10 hurdles.]

“By offering this updated platform, Edifecs is demonstrating its strong commitment to providing multi-stakeholder solutions that streamline administrative exchanges," said Gwendolyn Lohse, managing director of CORE and deputy director, CAQH. "Responding to the market transition to the latest version of HIPAA standards, the v5010 testing platform enables organizations interested in pursuing CORE certification to concurrently stay up-to-date with the CORE operating rules and industry standards."

More than 35 health plans, large provider groups and health IT vendors have used the Edifecs CORE Testing Online Service to become CORE-certified. UnitedHealth Group is the first organization to become CORE-certified using the updated CORE operating rules and the Edifecs v5010 testing platform.


“We recognize that interoperability among healthcare entities is critical to streamlining administrative processes and improving the overall quality of care,” said Sunny Singh, CEO of Edifecs, Inc. “Edifecs is pleased to be partnering with CAQH CORE to bring to market tools and services that will help advance this important initiative in compliance with current mandates.”