WorkCompEDI announced today that it is the first organization in the Property & Casualty (workers’ compensation, auto & personal injury) markets to achieve the Phase IV CAQH® Committee on Operating Rules for Information Exchange (CORE®) Phase IV Certification Seal.
The Phase IV CAQH CORE Operating Rules build upon the first three phases to develop a national set of infrastructure expectations across all HIPAA claims-related transactions. Transactions covered under Phase IV include acknowledgement of claims and prior authorization and offer significant savings potential.
Phase IV also contains the first operating rules for transactions between employers and health plans. The acknowledgements requirement for employee premium payments and enrollment and disenrollment in a health plan will reduce processing delays and avoidable errors by communicating in real-time the receipt and status of information.
