PRESS RELEASE 06/09/16
Health plan trading partners are increasingly seeking CORE Certification as a way to help their clients improve administrative processes and meet Affordable Care Act (ACA) requirements...
Press Release 09/28/16
Full industry collaboration is required to develop an effective approach to collecting, maintaining and disseminating accurate, high-quality data from healthcare providers, according to a new white paper from the non-profit alliance CAQH.
CAQH CORE Operating Rules
ACA Section 1104 requires HIPAA covered entities to be in compliance with the remaining ACA-mandated operating rules.
- Health claims or equivalent encounter information
- Health plan enrollment/disenrollment
- Health plan premium payments
- Referral certification and authorization
- Health claims attachments
2016 CAQH Index Data Collection
The CAQH Index is an ongoing measure of progress to electronic business transactions. Theis now availalble for health plans to submit data for numbers of transactions and costs per transaction, manual vs. electronic, for calendar year 2015.