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Testing Status Report
CAQH® CORE™ Phase II Certification Testing Status Report Herb Larsen, SVP Alliances Edifecs confidential © 2002-2008 Edifecs Corporate Summary: Leader in Compliance, Quality & Interoperability Solutions for Improving Business Performance Established 1996 (12 years), Privately Held Headquarters Bellevue, Washington Customers Global Markets: Over 1,100 top-tier accounts in banking, insurance, securities, utilities, and high tech. Healthcare: Over 350 clients Solutions • Data Quality and Compliance Adaptors: Improve the quality of transactional data, and ensure compliance with government, industry and community standards • Healthcare Transaction Gateway: Healthcare-centric, real-time, standards independent, multi-channel port that manages all transactional data Headcount ~100 (75 in Products & Engineering) Partners 2 Edifecs confidential © 2002-2008 Edifecs Healthcare Market Leadership: 350+ Customers/Partners Blue Plans Government Commercial / Others BCBS Association BCBS Alabama BCBS Arizona BCBS Colorado BCBS Florida BCBS Georgia BC Idaho BS Idaho BCBS Kansas City BCBS Louisiana BCBS Minnesota BCBS Missouri BCBS Northeastern NY BCBS Nevada BCBS New Jersey BCBS North Carolina BCBS North Dakota BCBS Oregon BC NE Pennsylvania BCBS Nevada BCBS Tennessee BCBS Utah BCBS W NY BS Washington Carefirst BCBS CMS Enforcement CMS Eligibility Alaska Medicaid California Medicaid CalOHI Colorado Medicaid DC Medicaid Florida Medicaid Georgia Medicaid Kentucky Medicaid Maine Medicaid Maryland Medicaid Michigan Medicaid Minnesota Medicaid Mississippi Medicaid Nebraska Medicaid New Hampshire New Jersey Medicaid New Mexico Medicaid New York Medicaid North Dakota Medicaid Oregon Medicaid South Carolina Medicaid Tennessee Medicaid Texas Medicaid Washington Medicaid West Virginia Medicaid Wyoming Medicaid TriCare BMC HealthNet Canseco Cigna Delta Dental of CA GHI Great West Life Group Health Cooperative HealthPartners Health Net Harvard Pilgrim HealthPartners Kaiser Permanente LA Care Magellan Matria Medica Molina Healthcare MedAvant/ ProxyMed Payformance TMG Health Tufts Health Plan Unicare United Healthcare ValueOptions ViPS WEA Trust Wellcare Workscape WPS Total Client Base: 24 Total Client Base: 30+ Total Client Base: 100+ Providers / Hospitals Abbott Laboratories ACM Allina Hospitals and Clinics Banner Health Systems Baylor Health Caremark International Clinical Labs of Hawaii Fairview Health System Fresenius Gambro Indian Health Service John Muir/Mt. Diablo Health System (JMMD) Mass Eye & Ear Meridian Healthcare Methodist Hospital Military Health (DoD) New England Medical Novasys Park Nicollet PharMerica Scott & White Memorial TMCMed Veterans Affairs Total Client Base: 100+ Edifecs Edifecsisisthe theMarket MarketLeader Leader 24 24Blue BluePlans Plans 30+ Government 30+ Government 100+ 100+Payers Payers 100+ Provider 100+ Provider 100+ 100+Partners/Vendors Partners/Vendors Clearinghouses / Vendors And Partners ACS Amisys-Synertech Availity CAQH/CORE CSC Claimsnet CNSI EDS Emdeon EnCore ENS Fox Systems IBM Inmediata MedAvant/Proxymed Microsoft MSI OAO Healthcare Oracle Perot Post-N-Track Quovadx Sun TIBCO Unisys Total Client Base: 100+ 3 Edifecs confidential © 2002-2008 Stakeholders Who Have Tested CORE Phase I with Edifecs – 93% ACS EDI Gateway MD On-Line Aetna MedAvant AthenaHealth MedData Anthem/WellPoint Medical Information Engineering AultCare Montefiore Medical Center Availity NaviMedix BCBS of North Carolina NoMoreClipboard BCBS of Tennessee Passport OneSource CSC Consulting Post-N-Track Emdeon RelayHealth EmergingHealth SSI GE Healthcare SureScripts-RxHub HMS VisionShare Mayo Clinic 4 Edifecs confidential © 2002-2008 Edifecs Invests in its Relationship with CAQH-CORE No-Cost Product Access and Development Effort No-cost Access to CORE Testing Portal powered by Edifecs Ramp Management for Stakeholders No-cost Access to Edifecs SpecBuilder rules development tool for CAQH and its consultants Phase II Deliverables: • Active participation in all rule development conference calls • Ongoing Alpha and Beta support • Over 1000 developer & business analyst hours for Phase II to date • Enhanced product functionality to meet all CAQH-CORE Phase II-specific requirements • Connectivity (Client and Server sides) • Dynamic test data generation • Dedicated Support for Phase II testing entities • Visual/Manual inspection by Analyst for Uploaded Verification Artifacts Currently in Alpha Testing, Beta Completion in October Production Anticipated in November, based on Beta feedback Edifecs is Committed to Continue Supporting CAQH 5 Edifecs confidential © 2002-2008 Edifecs Product Overview TRANSACTION GATEWAY SOLUTIONS Transaction Management Claims Correction Visibility, Accountability, Alerts, Reporting, Trading Partner Management/Maintenance Business-Friendly Views, with Facilitated Error Correction by non-technical Partner Staff Ramp Management Trading Partner Testing and Enablement USED FOR CORE TESTING DATA QUALITY & COMPLIANCE SOLUTIONS SpecBuilder Rules and Edits Management, test data generation, desktop testing and guideline publishing USED FOR CORE TESTING XEngine Runtime Validation, splitting, routing and error reporting 6 Edifecs confidential © 2002-2008 Edifecs Phase II Demonstration 7 Edifecs confidential © 2002-2008
