CORE Phase I Rules

Use of the CORE Phase I rules/policies is voluntary and open to all organizations with an interest in administrative data exchange. The CORE Phase I rules will be updated during Q3-2010 to address HIPAA 5010 requirements.

Organizations must sign a binding pledge to adopt, implement and comply with CORE Phase I rules. A CORE-authorized testing vendor must certify that their systems are CORE compliant within 180 days of signing the pledge.

CORE certification is tailored for providers, health plans, vendors and clearinghouses. Organizations that do not create, send or transmit data can sign the pledge and receive a CORE Endorser seal.

Below are the documents required to complete the CORE Phase I rules certification process. Click the link to view, print, or download the document(s). Click CORE Phase I Glossary for terms related to CORE Phase I rules.

The Complete Set of CORE Phase I Rules and Policies

CORE Policies (100-105)

100: Guiding Principles

101: Pledge

• CORE Seal Application
• HIPAA Attestation Form

102: Certification Policy

103: Exemption Policy

• Health Plan IT Exemption Request Form

104: Testing Policy

• CORE Phase I Master Test Suite
• CORE Phase I Master Test Bed Data

105: Enforcement Policy

CORE Operating Rules (150-157)

150: Batch Acknowledgements

151: Real Time Acknowledgements

152: Companion Guide Rule

153: Connectivity Rule

154: 270/271 Data Content Rule

155: Batch Response Time Rule

156: Real Time Response Rule

157: System Availability Rule

For more information about the CORE Phase I Rules, CORE Phase I certification or applying for a CORE seal, please contact CAQH at (202) 861-1492.