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Humana Announces CAQH CORE Phase III Certification

Certification reflective of company’s drive to enhance the provider and patient experience and drive usage of electronic medical records


Thursday, December 12, 2013 10:30 am EST



Public Company Information:

"Humana’s certification reflects our ongoing and sustained efforts to securely exchange patient information and our commitment to similarly helping providers"

LOUISVILLE, Ky.--(BUSINESS WIRE)--Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, today announced that it achieved The Council for Affordable Quality Healthcare (CAQH®) Committee on Operating Rules for Information Exchange (CORE®) Phase III Certification.

CAQH, a nonprofit alliance of health plans and trade associations, launched the CORE certification to help give providers consistent access to patient information before or at the time of service using the electronic system of their choice for any patient or health plan.

Humana has now achieved CAQH CORE Phase I, II and III Certifications.

“Humana’s certification reflects our ongoing and sustained efforts to securely exchange patient information and our commitment to similarly helping providers,” said Brian LeClaire, Senior Vice President and Chief Service and Information Officer, Humana. “As a result of electronically sharing information with providers, we help facilitate the best experience possible for our members.”

Phase III certification is the highest level an organization can achieve, and shows a commitment to reducing administrative burdens and costs. The process took four years to complete and was achieved before the national deadline for compliance of January 1, 2014.

The CORE rules have been implemented to eliminate the need for time-consuming phone calls and paperwork by physicians and their office staff, giving providers consistent access to patient coverage information. The CORE rules also advance the way health care industry leaders communicate and increase interoperability, which will help to fulfill the priorities of the national health IT agenda of building upon national standards to make electronic administrative data communications increasingly seamless, streamlined and predictable.

The CORE rules were developed by over 140 participating organizations, representing providers, vendors, health plans, the Centers for Disease Control and Prevention, state and federal government agencies, associations, standard-setting organizations and other healthcare organizations.

By achieving the CAQH CORE Phase III certification, Humana is not only in compliance with current legislation, but also demonstrates to clinicians its commitment to provide the best service and payment model available.

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:

  • Annual reports to stockholders;
  • Securities and Exchange Commission filings;
  • Most recent investor conference presentations;
  • Quarterly earnings news releases;
  • Replays of most recent earnings release conference calls;
  • Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors);
  • Corporate Governance information.

About CAQH

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.


Humana Corporate Communications
Alex J. Kepnes, 502-580-2990