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     Health Reform

November 18, 2011

NCVHS Enrollment Testimony by CAQH 

NCVHS Maintenance and Updating of Stds and ORs Testimony by CAQH

November 17, 2011

NCVHS Claims Attachment Testimony by CAQH 

September 6, 2011

CAQH CORE Comment Letter to CMS RE: CMS-0032-IFC

August 22, 2011

CAQH CORE Model Comment Letter RE: CMS-0032-IFC

August 1, 2011

CAQH CORE Request for CORE Participant Input on the July 8th IFR for Eligibility and Claim Status

(Supplement - Overview of CAQH CORE Phases I & II)

CAQH CORE and NACHA letter to NCVHS RE: Update on Draft CAQH CORE EFT and ERA Operating Rules

July 8, 2011

IFR Issued on CMS Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions

April 27-28, 2011
NCVHS Subcommittee on Standards: ACA Administrative Simplification Operating Rules Hearing

CORE Testimony on The Acknowledgment Transaction Standard
CORE written testimony
CORE presentation

CORE Testimony on Maintenance and Modifications to Standards and Operating Rules
CORE written testimony
CORE presentation

March 23, 2011
NCVHS Letter Issued to HHS Recommending CAQH CORE to Develop National EFT and ERA Operating Rules

December 3, 2010
NCVHS Subcommittee on Standards: ACA Administrative Simplification Operating Rules Hearing


Part I:

CORE Eligibility and Claims Status Update Testimony:
CORE written testimony
CORE oral testimony
(Set audio track to 50:00)
CORE presentation


Part II:

CORE ERA/EFT Testimony:
CORE written testimony
CORE oral testimony
(Set audio track to 4:25:30)

General

Search by date: CAQH CORE Activities Related to Upcoming Mandate (includes testimony at NCVHS Hearings)


More information on the Upcoming Operating Rules Mandate


  

CORE Phase II
Committed Organizations:

Are You Ready to Submit
Your Phase II Pledge?


  

THE PHASE II RULES

CORE Phase II
Scope and Rules


  

STATE ACTIVITIES

CORE State Activity


  

UPCOMING CORE PRESENTATIONS:

NCPDP Standards in Pharmacy Rules and Regulations: From Inception to Implementation
2/7/12

HIMSS12 Annual Conference & Exhibition
CAQH Booth #9013
2/20/12 - 2/24/12

20th National HIPAA Summit
3/26/12 - 3/28/12

NACHA Payments 2012
4/29/12 - 5/2/12

21st Annual WEDI National Conference

4/30/12 - 5/3/2012

View the complete list of 2012 CORE presentations.


CORE Overview Presentation


CORE Provider Presentation

CORE Endorsement Application Process

Instructions

Entities that do not use, create, or transmit eligibility and/or claim status data* can demonstrate their support for CORE’s mission and its rules by signing the CORE Pledge, and applying for and using the CORE Endorser Seal. Entities seeking the CORE Endorser Seal should complete the following steps:

  1. Obtain and review the Rules and Policies
  2. Obtain and review the Certification Policy
  3. Obtain, review and sign the Pledge
  4. Obtain and complete the Seal Application
  5. Submit the signed CORE Pledge with the completed CORE Seal Application to:
    CORE Endorser
    CAQH
    601 Pennsylvania Avenue, NW
    South Building, Suite 500
    Washington, DC 20004

CORE Endorsement Terms and Conditions

  • CORE Phase I Endorser status is valid for CORE Phase I Rules; CORE Phase II Endorser status is valid for CORE Phase II Rules, etc. Entities will need to apply for a CORE Endorser Seal for each new phase of CORE rules they desire to support, including each substantive change made to CORE Phase I and additional Phase rules.

  • There is no fee required to apply for and use the CORE Phase I Endorser Seal.

  • CORE will inform each CORE Endorser Seal applicant of its queue status at the time the application is received.

  • Upon receiving a CORE Endorser Seal application from an entity, CORE will have a maximum of 20 business days to complete its assessment of the application and respond to the applicant with a clear response of approval or need for clarification.

  • A final decision will be made by CORE in 30 business days, unless there are extenuating circumstances. If so, CORE will notify the applicant about the reason for the assessment extension.

  • CORE will grant an organization its CORE Endorser Seal following the positive completion of the application review process.

  • After receiving a CORE Endorser Seal, the entity may market itself as a CORE Endorser.

  • Entities receiving the CORE Endorser Seal will be promoted in CORE marketing materials and on the CAQH website.


* Only entities that use, create, or transmit eligibility or claim status data are eligible for CORE certification. Such entities should refer to the CORE Certification: A Step-By-Step Process for more information about becoming CORE certified.

Questions: Contact CAQH at (202) 861-6380 or core@caqh.org