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Physicians Health Plan simplifies insurance verification process

Wednesday, November 4, 2015   (0 Comments)
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Physicians Health Plan simplifies insurance verification process

LANSING, MI — Physicians Health Plan (PHP) announced today that it is part of an initiative to reduce unnecessary and costly health care administrative processes, making health care a more efficient and responsive experience for Patients and Caregivers.

PHP recently earned its Council for Affordable Quality Healthcare (CAQH®) Committee on Operating Rules for Information Exchange (CORE®) Phase 2 Endorser Seal, demonstrating its commitment to streamlining electronic health care administrative data exchange.

“PHP reached a huge milestone on Tuesday, Nov. 3, when it met the challenging requirements for this certification,” said PHP President and CEO Dennis Reese. “By processing real-time eligibility and claim status electronically, PHP will benefit from reduced operating costs and increased provider satisfaction.”

CAQH, a nonprofit alliance of health plans and trade associations, launched CORE to improve operations between health plans and providers, and enhance provider access to administrative information.

To date, the voluntary industry-wide initiative has brought together more than 100 health care industry stakeholders – covering more than 130 million people, or more than 75 percent of the commercially insured plus Medicare and state-based Medicaid beneficiaries– to make electronic administrative data communications seamless, streamlined and predictable, regardless of the technology. In many cases the CORE rules eliminate the need for practice staff phone calls.




“The CORE rules represent a cutting-edge approach to improving electronic communication between providers and payer organizations," said Robin J. Thomashauer, CAQH executive director. "By becoming a CORE Endorser, PHP is demonstrating its support for an initiative that is reducing unnecessary health care administrative burden, and helping U.S. health care become more efficient and responsive to patient concerns.”

About CAQH:  CAQH serves as a catalyst for industry collaboration on initiatives that simplify healthcare administration for health plans and providers, resulting in a better care experience for patients and caregivers. CAQH solutions help promote quality interactions between plans, providers and other stakeholders, reduce costs and frustrations associated with healthcare administration, facilitate administrative healthcare information exchange and encourage administrative and clinical data integration. Visit for more information.



Sparrow, a member of the prestigious Mayo Clinic Care Network, is mid-Michigan’s premier healthcare organization that includes hospitals in Lansing, St. Johns, Ionia and Carson City as well as Physicians Health Plan, Sparrow Physicians Health Network, the Sparrow Medical Group and the Michigan Athletic Club. Sparrow is affiliated with Michigan State University’s three human health colleges. Through these partnerships and the dedication of our 10,000 Caregivers, Sparrow pursues a vision to be nationally recognized as a leader in quality and Patient experience. For more information, visit

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