Blue Cross and Blue Shield of Nebraska awarded CORE certification for electronic information management

The CAQH Committee on Operating Rules for Information Exchange (CORE®) has awarded a CORE Certifications to Blue Cross and Blue Shield of Nebraska (BCBSNE).

Widely regarded as a must-have seal of approval across the healthcare industry, CORE Certification signifies that BCBSNE follows a set of HIPAA-mandated standards and operating rules for exchanging electronic administrative data.

“Today we are announcing an important milestone in the effort to streamline administration and improve electronic data sharing across our nation’s healthcare system,” said George S. Conklin, Senior Vice President and Chief Information Officer, CHRISTUS Health and CAQH CORE Board Chair. “It is vital that we have an independent certifying body for operating rules and standards and, with this achievement, there is no question CORE Certification is the gold standard.”


The Affordable Care Act mandated the creation of operating rules to improve the efficiency, accuracy and security of billions of healthcare administrative transactions and established stiff penalties to enforce them. 

For consumers, the operating rules hold the promise of a healthcare system with fewer frustrating paperwork errors, more secure information and lower costs.



The percentage of the bill you pay after your deductible has been met.


A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 


The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.


Includes behavioral health treatment, counseling, and psychotherapy

in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)


Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.


If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.


The amount you pay to your health insurance company each month. 

Preventive services

Health care services that focus on the prevention of disease and health maintenance.


Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).


A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.