Re the real-time conduct of the paired 270/271 and 276/277 transactions it’s 
probably worthwhile for folks here to know about the CAQH/CORE operating rules. 
(all the information about CAQH and CORE can be found at www.caqh.org)

 

Essentially, the CORE operating rules have and are being developed in a 
consensus-based process by health industry-wide collaboration of more than 100 
multi-type stakeholders (providers, health plans, clearinghouses, vendors). The 
CORE operating rules require that the eligibility and claim status 
request/response transactions be conducted in real-time with 20 seconds or less 
response time (total round trip). There are other operating rules that address 
other “infrastructure” and data content requirements. Infrastructure addresses 
not only real time requirements, but also system availability, the use of the 
X12 TA1 and 997 acknowledgements for both real time and batch. The CORE Phase I 
and some of the Phase II operating rules have been incorporated into the HITSP 
interoperability specifications (www.hitsp.org) Phase III of CORE operating 
rule developing will be launched in early 2009.

 

Industry adoption of the CORE operating rules is proceeding at an increasing 
pace – see the 12/30/08 press release inserted below.

 

And regardless of whether one assumes that all of these transactions are 
“classic” batch information exchanges, there is really nothing in them that 
precludes them from being conducted in real time. 

 

 

CAQH PRESS RELEASE 

 

ORGANIZATIONS SUPPORT CAQH INITIATIVE TO IMPROVE PATIENT ADMINISTRATIVE DATA 
ACCESS

Washington, D.C. (December 30, 2008) − The American Academy of Family 
Physicians (AAFP); Gateway EDI; MD On-Line, Inc.; mPay Gateway, Inc.; RealMed 
Corp.; Secure EDI Health Group, LLC; and Summit Medical Group have stepped up 
their commitment to improving provider and hospital access to consistent 
electronic patient administrative data through the CAQH Committee on Operating 
Rules for Information Exchange  
<http://rs6.net/tn.jsp?e=001dWtXIdbPJKdSFtG1IyaEC2QjOe1GCiWhMwRSk4P2yMcyf77OcCsFGPAnwpWp5He8bp4Eoq9z1qKeVV4L2_ijxb7VufW8UaxoyYcyQYPtlnuUKucPH425Ug==>
 (CORE) initiative.

A nonprofit alliance of health plans and trade associations, CAQH launched CORE 
to create an all-payer solution that enables provider access to patient 
insurance information before or at the time of service using the electronic 
system of their choice. The organization has brought together more than 100 
industry stakeholders to collaborate on a multi-phase set of uniform business 
rules to achieve that goal.

MD On-Line, Inc.; RealMed Corp.; and Summit Medical Group have completed a 
testing process to certify their systems or product meet CORE Phase I  
<http://rs6.net/tn.jsp?e=001dWtXIdbPJKcEs7GQJ0eH5qdSV9laG9bx_Uz95iY9LJtzzZID3JUhBWjiO0fll5APUme7hCJM5G80V0l3t5QtreToOYiASpNyZpNb4rtjQ0GegwmAlBHPaeyiJENCB3Nh>
 rules requirements. MD On-Line, a clearinghouse processing in excess of 2 
million electronic transactions per month, certified its ACCE$$ - Patient 
Eligibility Verification product. RealMed, a healthcare revenue cycle 
management services vendor serving approximately 22,000 physicians and health 
care professionals representing nearly 900 distinct medical groups including 
physician practices, academic medical centers, national laboratories and 
medical billing services certified its RealMed Revenue Cycle Management 
internet based product. Summit Medical Group, which includes 200 physicians in 
50 office locations and 10 hospitals serving patients in nine Tennessee 
counties, was certified as a large provider group.

These three organizations join more than 30 other entities, including health 
plans covering approximately 65 million or one-third of U.S. commercially 
insured lives, that are certified as operating in compliance with the  
<http://rs6.net/tn.jsp?e=001dWtXIdbPJKfG5r6I1TDegeN3G1mXaeFG7XEkdel_jLlc2AcHUK4JtbXM1QVlb6cmKYrKDB9da-S9a01gKcf0KCvVju-hkprxAQxKcHuVv4ZI26JEx0M1hmaAsLbrljoG>
 CORE Phase I rules.

Built upon national standards, including HIPAA, CORE rules make electronic 
administrative data communications seamless, streamlined and predictable, 
regardless of the technology – in many cases eliminating the need for 
time-consuming phone calls and paperwork.

In anticipation of the industry moving from HIPAA Version 4010 to Version 5010, 
CORE Phase I and Phase II rules incorporate many of the features found in the 
X12 5010 TR3s to address the common information needs for patient eligibility.

Gateway EDI; mPay Gateway, Inc.; and Secure EDI Health Group, LLC; all health 
IT vendors, joined CORE to participate in developing additional phases of the 
CORE rules.

AAFP received CORE Phase II rules Endorser status this past summer.

CORE participants have begun the process to develop Phase III rules, which will 
focus on improving the electronic exchange of additional administrative 
transactions, such as prior authorization and remittance advice.

About CAQH
CAQH is a catalyst for healthcare industry collaboration on initiatives that 
simplify and streamline healthcare administration. CAQH solutions help promote 
quality interactions between plans, providers and other stakeholders, reduce 
costs and frustrations associated with healthcare administration, facilitate 
administrative healthcare information exchange and encourage administrative and 
clinical data integration. Visit  
<http://rs6.net/tn.jsp?e=001dWtXIdbPJKfdWsDcsIzsw-t0d-7_aRijoeSLrd0zUPUnEbZ-nkfYLLyxtOPOkCIV31QMV0xqn8zYbm8y0FHHt5bo1G63Qv4YKYByHXk-bM4=>
 www.caqh.org for more information.

 

 

Rachel Foerster

Senior CAQH/CORE Consultant

Boundary Information Group 

 

Rachel Foerster & Associates Ltd.

39432 North Avenue

Beach Park, IL 60099

Phone: 847-872-8070

www.rfa-edi.com

RFA Ltd Framed New Logo

 

 

From: [email protected] [mailto:[email protected]] On Behalf Of Michael 
Mattias/LS
Sent: Wednesday, December 31, 2008 10:23 AM
To: EDI-L
Subject: Re: [EDI-L] Any realtime issues when implementing 270, 271, 276, 277, 
834, 835, 820

 

12/31/08

> Please help me with above messages, if anyone who worked on it, had
> face some challenges or issues that they want to share.

"Issues" and "challenges" is kind of vague, isn't it?

First of all, the only documents above where you should even be 'thinking' 
about 'realtime' are the 270/271 pair; all the others are essentially 
'classic' batch-type business transactions.

Second, I have found the ANSI EDI portion of "handling" the 270/271 document 
pair far less challenging than getting the ERP system (or humans) to provide 
the information required to fully support the 271 response.

AFAIK, most payers send the 271 with only the "covered Yes/No" info and few 
provide the pricing (allowed, copays , deductibles, etc) info.

Michael C. Mattias
Tal Systems Inc.
Racine WI
[email protected] <mailto:mmattias%40talsystems.com> 



[Non-text portions of this message have been removed]


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