TABLE 19-1CORE-5010 Crossover: Eligibility Inquiry—Patient Financials

Patient FinancialRequired by CORE Phase I Since 4/06 or CORE Phase II Since 7/08 (either 6 or 4 years prior to 5010)Recommended by 5010 (not mandated)
CopayXX
CoinsuranceXX
Deductible (static)XX
YTD deductible (remaining)X (Phase II)No
In-out of network variancesXNo

NOTE: YTD = year to date.

SOURCE: Reprinted with permission from CAQH, 2009a.

From: 19, Administrative Simplification

Cover of The Healthcare Imperative
The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary.
Institute of Medicine (US) Roundtable on Evidence-Based Medicine; Yong PL, Saunders RS, Olsen LA, editors.
Washington (DC): National Academies Press (US); 2010.
Copyright © 2010, National Academy of Sciences.

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