The healthcare industry has complex and challenging industry standards. Centene Corporation and its subsidiaries strive to not only meet, but exceed, these standards to provide quality healthcare to each of its members. Centene is proud to be formally recognized for going above-and-beyond industry standards through certifications and accreditations by some of the nation’s top healthcare organizations.
Centene standardizes information provided to healthcare providers. The Committee on Operating Rules for Information Exchange (CORE) is an initiative by a non-profit alliance of health plans, networks and trade associations to simplify healthcare administration. With CORE certification, Centene joins others in standardizing the information sent to providers, so they receive consistent, uniform information from each insurer. CORE certification helps providers offer the best possible care consistently to each member, which in turn helps members maintain better health. It also improves interactions between health insurers and providers, reduce costs and administrative hassles, meet HIPAA requirements, and increase accuracy and speed in paying claims. Centene is pleased to announce that it has received a CAQH CORE® health plan certification seal and is now exchanging electronic administrative data in compliance with the CORE rules. For more information about CORE, please visit www.caqh.org/CORE_overview.php or contact CAQH at (202) 861-6380.
The National Committee for Quality Assurance (NCQA) evaluates the quality of key processes and systems health plans provide their members. NCQA is a private, non-profit organization working to improving healthcare quality through measurement, transparency and accountability. The accreditation process involves a team of NCQA-trained healthcare experts conducting an extensive review, which includes an on-site survey of each health plan being considered for accreditation, and annual reporting of performance measures. Centene’s subsidiaries strive for this level of quality in all aspects of the business; several Centene subsidiaries are currently accredited or certified by NCQA and many others are working towards accreditation or certification, as applicable. The following subsidiaries currently hold NCQA accreditation:
URAC, formerly known as the Utilization Review Accreditation Commission, is the nation’s largest accreditor of healthcare companies. An independent, non-profit organization, URAC develops standards with the help of nationwide experts in healthcare, including providers, insurers, healthcare organizations and public interest groups. Many of Centene’s specialty companies are URAC certified or are actively working to become recognized by this organization. The following subsidiaries currently hold URAC accreditation: