Humana has received each of the CAQH CORE Information Exchange Certification seals.
These CORE certifications signify Humana's commitment to:
- Improve access to patient insurance eligibility and benefit information.
- Standardize the enrollment process for electronic funds transfer (EFT) and electronic remittance advice (ERA).
- Deliver an industry-uniform use of claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs)
- Support critical privacy and security practices.
Clinicians and other health care providers who want to learn how CORE operating rules will affect them can visit this CORE Web page
for more information.
Health plan identifier (HPID)
On Oct. 31, 2014, the Centers for Medicare & Medicaid Services (CMS) Office of E-Health Standards and Services (OESS) announced a delay in the enforcement of 45 CFR 162, Subpart E, the regulations pertaining to health plan enumeration and use of the health plan identifier (HPID) in HIPAA transactions adopted in the HPID final rule (CMS-0040-F). This enforcement delay applies to all HIPAA-covered entities, including clinicians and other health care providers, health plans and health care clearinghouses.
On Sept. 23, 2014, the National Committee on Vital and Health Statistics (NCVHS), an advisory body to the Department of Health & Human Services (HHS), recommended that HHS rectify in rulemaking that all covered entities (health plans, clinicians and other health care providers and clearinghouses and their business associates) not use the HPID in HIPAA transactions.
For more information on health plan identifiers, go to: http://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/Affordable-Care-Act/Health-Plan-Identifier.html.
Health care exchanges
Health care exchanges are mandated by the Affordable Care Act (ACA) and are to be managed at the state level to offer basic health benefit plans to people who are not part of a group and don’t have other coverage available to them. For more information, visit this CMS website:
For more information about HIPAA guidelines, visit
This information is only a high-level summary of certain provisions of the health care reform law. This information does NOT attempt to summarize all provisions of the health care reform law. This information is not and should NOT be used as legal or tax advice, nor should it be used as a basis for decisions regarding how the health care reform law will affect you and/or your business. Questions on how the health care reform law will affect you and/or your business should be directed to attorneys or other professional advisers.