Medical Informatics Engineering (MIE) is the first EMR vendor certified by the CAQH Committee on Operating Rules for Information Exchange (CORE) this week, after demonstrating that its WebChart EMR can successfully interoperate with participating health plans and healthcare providers.
CAQH, a nonprofit alliance of leading health plans, networks and trade associations, has developed standard business rules for information exchange that enable healthcare providers to electronically access health insurance eligibility and benefit information in a matter of seconds. These rules build on the HIPAA eligibility (X12 270/271) transaction.
Providers currently call health plans to obtain and verify insurance information, or they use online interfaces provided by individual health plans. This time-consuming process requires medical practices to devote significant staff resources to confirming insurance coverage.
Providers utilizing the MIE WebChart EMR can now automate the process of securing health plan information. In advance of a patient appointment, the WebChart EMR will generate an ANSI-270 message to the patient health plan. Within seconds, the health plan will issue a comprehensive ANSI-271 response that includes verification of health insurance eligibility and information on plan coverage, deductibles and co-pays. This information will automatically populate the EMR and become part of the patient medical record. This transaction not only saves provider and health plan administrative staff time, it enables the practice to collect co-pays at the time of service and can reduce eligibility-related bad debt and claims denials.
"CORE Certification underscores our commitment to interoperable electronic communication," stated MIE executive vice president Peter Norder. "We were in the first group to receive CCHITSM Certification for our WebChart EMR, and now we are the very first EMR vendor to receive CORE Certification."
"Interoperability is a critical building block in our minimally invasive EHR strategy," added Norder. "We develop and deploy EHR solutions that improve efficiency while minimizing practice upheaval, IT investment and custom integration requirements."
In addition to MIE, nearly 20 leading health organizations have begun voluntarily exchanging patient administrative data in accordance with the CORE rules, including Aetna, Inc., Mayo Clinic, and WellPoint, Inc. and its 14 Blue Cross and Blue Shield-licensed subsidiaries.