HTP Achieves CORE Certification for Healthcare Information Exchange

HTP, Inc., a leading developer of software for the healthcare industry, announced that its HTP RevRunner™ revenue enhancement software suite has received a CAQH Committee on Operating Rules for Information Exchange (CORE) Vendor certification seal. The seal was awarded after HTP RevRunner successfully completed Phase I certification testing – a process ensuring that healthcare information technology can electronically exchange and verify insurance eligibility and benefits information according to CORE Phase I rules.

"We are proud to become an early adopter of these important standards for health information exchange," said HTP President and CEO Ray Shealy. "Achieving CORE certification demonstrates HTP RevRunner’s ability to speed the exchange of eligibility and benefits data for our clients."

HTP Co-founder and Chief Technology Officer Fred Richards, a founding member of CORE, helped to develop the operating rules, which build on existing standards such as HIPAA to make electronic transactions more efficient, predictable and consistent. The rules are modeled on those that make ATM transactions an everyday occurrence in the banking industry and keep electricity flowing in the power industry.

CORE certification ensures that HTP RevRunner users can securely process eligibility queries within 20 seconds and that their data is formatted correctly for direct exchange with health plans and other payers. The ability to verify a patient’s insurance coverage in real time shortens the registration process and speeds claims processing.

Hospitals using HTP RevRunner have uncovered patient insurance eligibility covering millions of dollars in services that had previously been categorized as self-pay accounts or written off as uncollectible. The product suite is based on industry recognized best practices for revenue cycle management. It uses government standards and business intelligence to supplement existing billing practices, helping providers quickly verify patient insurance information and maximize reimbursement.

"The CORE rules represent a revolutionary step toward health plan-provider interoperability," said Robin J. Thomashauer, executive director of CAQH (Council for Affordable Quality Healthcare). "By adopting the rules, HTP is reducing unnecessary healthcare administrative burden, and helping U.S. healthcare become more efficient and responsive to patient concerns."

The CAQH launched CORE to promote health plan-provider interoperability and improve provider access to administrative information. To date, the voluntary industry-wide initiative has brought together nearly 100 healthcare industry stakeholders – health plans, providers, vendors, CMS and other government agencies, associations, regional entities, standard-setting organizations and banking industry experts – to develop the operating rules. Those stakeholders cover more than 130 million lives, or more than 75 percent of the commercially insured plus Medicare and state-based Medicaid beneficiaries.

The CORE initiative has begun its second phase rules development process, which is scheduled to run through late 2007.