Industry: Healthcare

Only Portal Provider Awarded Six CORE Certifications

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Our high-level compliance with interoperability operating rules and industry standards allows us to act as a turnkey partner, ready to meet CMS requirements, helping our clients seamlessly connect trading partners into their existing business and application workflow.


TUCSON, Ariz. (PRWEB)

HealthTrio has been awarded three additional certifications from CAQH CORE Operating Rules, formerly known as Phase IV, which includes Prior Authorization and Referrals, Health Care Claims, and Benefit Enrollment, making HealthTrio the only member and provider engagement platform that has achieved this level of interoperability operating standards and data efficiency.

“At HealthTrio, we provide real-time solutions certifiably proven to deliver easier, more reliable data sharing and exchange, thereby reducing time on administrative tasks for plans and providers,” said Dominic Wallen, President and COO, HealthTrio. “Our high-level compliance with interoperability operating rules and industry standards allows us to act as a turnkey partner, ready to meet CMS requirements, helping our clients seamlessly connect trading partners into their existing business and application workflow.”

Awarded by The Council for Affordable Quality Healthcare, Inc (CAQH), the Committee on Operating Rules for Information Exchange (CORE) Operating Rules systemize common business practices to simplify data sharing among between multiple parties. Recently CAQH has updated their certification model to a transaction-based approach; HealthTrio has all six of the below certifications:


  • Eligibility and Benefits: Eligibility (270/271) Infrastructure Rule, Eligibility (270/271) Data Consent Rule

  • Claim Status: Claim Status (276/277) Infrastructure Rule

  • Payment and Remittance: Claim Payment/Advice (835) Infrastructure Rule, EFT/ERA 835/CCD+ Data Content Rule, EFT/ERA Enrollment Data Rules

  • Prior Authorization and Referrals: Prior Authorization (278) Infrastructure Rules, Prior Authorization (278) Data Content Rule, Prior Authorization Web Portal Rule

  • Health Care Claims: HealthCare Claim (837) Infrastructure Rule

  • Benefit Enrollment: Benefit Enrollment (834) Infrastructure Rule


“Receiving this level of CAQH CORE certifications is a huge achievement for us, our clients and the members. We’re able to deliver real-time review and validation of the data, helping to decrease turnaround time and reduce the cost of care,” said Wallen. “We strive to continuously improve and perform ahead of the curve for our clients, and we’re happy to provide yet another benchmark for them.”

About HealthTrio:

HealthTrio provides digital engagement solutions that optimize self-service, value-based care, healthcare consumerism and real-time data integration. Our selection of tools is as broad as the markets we serve – from everyday tools such as eligibility, benefits and claims to advanced features supporting provider quality performance, cost transparency and automated authorizations. With in-depth security capabilities, HealthTrio’s platform extends beyond the traditional member, provider, employer and broker access to include guests, caregivers, community-based organizations and a variety of other user types. For over twenty years, HealthTrio has supported health plans, administrators and integrated delivery networks to decrease costs, increase access and improve health outcomes.

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