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Noridian and CORE Connectivity Implementation

Beginning 4/3/2017 EDISS will begin supporting CORE Connectivity and the associated transactions through the new EDISS Gateway. The first phase of CORE Implementation will apply to the Medicare Line of Business.

 

What is CORE Connectivity?

CORE Connectivity uses HTTPS Connectivity which is communication over a secured internet connection. Transactions are sent using an ‘envelope.’ Envelopes can be either a SOAP (Simple Object Access Protocol) or MIME (Multipurpose Internet Mail Extensions) envelope.

Rules around this connectivity were established as part of the Affordable Care Act.

Trading partners using HTTPS in TIBCO will not receive User ID’s or Passwords. Connections will be secured using X.509 certificates.

NOTE: CORE transactions are not submitted through any type of user portal. Interested Submitters must purchase an X.509 Certificate and have working knowledge and familiarity with the CORE Operating Rules.

To learn more about CORE Connectivity and X.509 Certificates please visit WWW.CAQH.ORG.

 

Registration and Timeline

Beginning 4/3/2017, Medicare trading partners will be able to register to send 276-277 and 835 transactions using HTTPS (CORE) connectivity. CORE registration can be completed through EDISS Connect.

Note: 837 Electronic Claim submissions will not be allowed for Medicare.

At this time Commercial Lines of Business are able to registration for CORE transactions but EDISS will not be processing these transactions at this immediate time. This functionality will be introduced in the coming months.

Below is a table that breaks down EDISS’s existing Lines of Business and CORE Transactions that will be supported.

 

Line of Business: Transactions: EDI Readiness:
Medicare Part A and Part B 276-277 (Batch and Real Time)
835
4/3/17
BCBSND and BCBSWY 270-271 (Batch and Real Time)
276-277 (Batch and Real Time)
278 (Real Time)
820
834
835
837
TBD
IAMCD 270-271 (Batch and Real Time)
276-277 (Batch and Real Time)
835
837
TBD

 

NOTE: Existing submitters using CORE connectivity with EDISS today will be transitioned into the new Gateway in the near future. They may be required to work with EDISS to recreate a CORE EDISS account. They will also need to use X.509 certificates for authentication at a later date.