- Contributing to Enhanced Healthcare Administrative Data Exchange and Interoperability
GREENWOOD VILLAGE, Colo., Dec. 14, 2010 /PRNewswire/ -- Recondo Technology, a leading provider of revenue cycle solutions for the healthcare industry, announced today that Recondo has achieved CAQH® Committee on Operating Rules for Information Exchange® (CORE®) Phase II Certification. The CORE Seal was awarded after Recondo SurePayHealth successfully completed CORE Phase II certification testing, a process ensuring that healthcare organizations can electronically exchange or access patient insurance information conforming to the CAQH CORE Phase II rules.
"The CORE rules represent a cutting-edge approach to streamlining electronic administrative data exchange," said Robin J. Thomashauer, CAQH executive director. "By adopting the rules and completing CORE Phase I and Phase II certification, Recondo Technology is reducing unnecessary healthcare administrative burden, and helping U.S. healthcare become more efficient and responsive to patient concerns."
"Recondo streamlines data communication between payers and providers, delivering significant business benefits to our customers. Recondo understands quite well the pressure of increasingly complex insurance processing rules and the associated manual intervention, errors, and rework," said Rick Adam, Recondo CEO. "The CORE rules help drive accuracy and consistency across Electronic Data Interchange (EDI) transactions, significantly lowering administrative costs for both payers and providers. We worked hard to achieve Phase II certification, which allows Recondo to extend our technology to more and more hospitals."
The CORE Phase II rules are advancing the way the healthcare industry communicates and are increasing interoperability, which will help to fulfill the priorities of the national health IT agenda. CORE Phase II certification means providers working with these plans can access a richer set of consistent and accurate electronic administrative data, such as eligibility, benefits, and patient financial information. The Phase II rules also enable improved access to claims status, which was not included in Phase I.
The CORE Phase II rules, which build upon national standards, including the Health Insurance Portability and Accountability Act (HIPAA), make electronic administrative data communications increasingly seamless, streamlined and predictable, regardless of technology. The CORE rules are being implemented to eliminate the need for time-consuming, costly phone calls and paperwork by physicians and their office staff, freeing up time to focus on patient care.
CAQH, a nonprofit alliance of health plans and trade associations, launched CORE to promote health plan-provider interoperability and improve provider access to administrative information. The CORE rules are being developed by over 115 participating organizations, representing providers, vendors, health plans, CMS, state and federal government agencies, associations, standard-setting organizations and other healthcare organizations. More than 20 leading health plans, large provider groups and technology vendors have completed Phase II rules certification. Recondo Technology is among these organizations. CORE participants are currently developing the Phase III rules, which build upon Phase I and Phase II. The third set of rules focuses on improving the electronic exchange of additional administrative transactions, such as prior authorization and remittance advice.
"The CORE Phase II rules represent a transparent, consensus-based national approach to an expanded set of operating rules for electronic administrative transactions among providers, health plans and vendors," said Robin Thomashauer, CAQH executive director. "By completing CORE Phase II certification, Recondo Technology is making it easier for everyone to exchange real-time administrative transactions more effectively, thereby improving efficiency and freeing up time for physicians to focus on their patients."
A CAQH study by IBM Global Business Services found that industry-wide implementation of the CORE Phase I rules alone could yield $3 billion in healthcare savings. Widespread adoption of the Phase II rules and subsequent phases of CORE will result in even higher savings for stakeholders across the industry.
About Recondo Technology
Recondo Technology delivers powerful software services connecting patients, providers, and payers across the US healthcare spectrum. Recondo services bring efficiencies and cost savings to healthcare payment processing, which currently costs US healthcare a staggering $375 billion in annual expense. Recondo services automate the revenue cycle and payment cycle, from pre-scheduling to adjudication, with virtually no manual intervention.
SurePayHealth® offers an accurate statement of patient financial responsibility at Point of Service, verifying patient identity, eligibility, and benefits, and accurately calculating the patient fee. After activating SurePayHealth, hospitals increase cash collections by tens of thousands of dollars every month.
EligibilityPlus™ gives hospitals the most complete view of government and commercial insurance benefits available in the industry. With a complete understanding of insurance benefits, hospitals immediately identify specific coverage, simplify patient registration workflows, reduce claim rework, and assess patient liability.
Authorization-Denial Prevention (Auth-DP) increases cash flow by reducing a hospital's costly payer denials. Auth-DP identifies precertification requirements and authorization at the front of the revenue cycle, increasing authorization coverage and reducing denials by as much as 75 percent.
Financial Assistance helps hospitals identify the most likely payment source for each patient, determine initial likelihood to qualify for Medicaid and offer state-specific Medicaid assessments and applications (for every state), automate evaluation and classification of "presumptive" charity, including propensity to pay.
Recondo services are Software as a Service (SaaS), requiring no capital budget and no additional hardware or software installation. Recondo services are developed using high-speed, high-volume rules-based processing, giving hospitals unmatched and immediate access to real-time data. Visit Recondo Technology at www.recondotech.com.
CAQH serves as a catalyst for industry collaboration on initiatives that simplify healthcare administration for health plans and providers, resulting in a better care experience for patients and caregivers. 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 www.caqh.org for more information.
SOURCE Recondo Technology