Affordable Quality Healthcare Providers
Member Calendar Login

User ID (case sensitive)
Password (case sensitive)

SET TEXT SIZE
Small Font Medium Font Large Font


Physicians and other health providers are now using this industry standard for provider data collection



     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.

Executive Staff

Robin J. Thomashauer
Executive Director

As Executive Director of CAQH, Robin Thomashauer leads a broad based coalition of health plans and trade associations dedicated to creating solutions that dramatically streamline healthcare administration. A recognized industry leader, Thomashauer has more than 30 years of experience in managed care operations and hospital administration.

Prior to joining CAQH, Thomashauer served as a Director in the PricewaterhouseCoopers Healthcare Consulting practice. She has also served as an executive manager in several health care organizations, including the Kaiser Foundation Health Plan, overseeing a wide range of functions, including Medical Facilities, Clinical Services, Information Systems, Strategic Planning, Public Affairs and Alliances/Acquisitions. Thomashauer has also held management and administrative roles in several teaching hospitals, including Rockford Memorial Hospital in Rockford, Illinois, and Mercy Hospital in Chicago, Illinois.

Thomashauer is a Diplomate in the American College of Healthcare Executives and serves on the board for Adventist Healthcare. She holds an M.H.S.A in Hospital Administration from The George Washington University and a B.A in Social Sciences from Colgate University.

Gwendolyn Lohse
Deputy Director
Managing Director, Committee on Operating Rules for Information Exchange

Gwendolyn Lohse is the Managing Director of the Committee on Operating Rules for Information Exchange (CORE) at CAQH, a nonprofit alliance of leading health plans and industry trade associations located in Washington, D.C. CAQH’s mission is to be the catalyst for industry collaboration on initiatives that simplify healthcare administration, resulting in a better care experience for patients and caregivers.

CORE creates national business rules to govern the electronic exchange of administrative data, regardless of technology. To demonstrate their adoption of the CORE rules, entities must complete a certification process that verifies that their IT systems and products are in compliance with the rules. Lohse led the design and implementation of CORE, and oversees the day-to-day aspects.

Under her leadership, over 130 organizations, including health plans, hospitals, vendors, CMS, and other healthcare industry leaders, have joined CORE. CORE participants collectively cover more than 150 million lives, or approximately 75 percent of the commercially insured plus Medicare and some state-based Medicaid beneficiaries. Numerous leading national healthcare organizations have completed CORE certification or become CORE Endorsers. Lohse currently is overseeing CORE’s third phase of rules development.

Prior to joining CAQH, Lohse was a Manager at PricewaterhouseCoopers (PwC), serving both domestic and international healthcare clients, and an associate within Johns Hopkins’ internal consulting unit.

Sorin Davis
Managing Director, Universal Provider Datasource

With more than 30 years in health insurance, healthcare management, benefits administration, and sales/marketing, Sorin Davis has served the healthcare industry from many perspectives.

Davis currently supports CAQH, a not-for-profit alliance of the nation’s leading health plans and trade associations as its Managing Director of the Universal Provider Datasource (UPD). He is responsible for the national launch and day-to-day operations of the UPD initiative. His primary focus is on overall UPD product strategy as well as oversight of the vendor which provides development, administrative and operational support of the UPD platform.

Previously, Davis was Executive Vice President of MultiPlan, and CEO of its subsidiary, CareAway USA, providing services to over 200 HMOs. During his tenure, he was instrumental in transforming MultiPlan into one of the nation’s largest and best known independent PPOs. He also represented MultiPlan, as its deputy board member to CAQH. Before MultiPlan, Davis was Director of Labor Sales and Account Management at Empire Blue Cross, leading the team responsible for the then largest block of labor healthcare business in the country. Earlier, he was Director of Claims Administration for the Amalgamated Life Insurance Company, and Assistant Administrator of the International Ladies Garment Workers Union Health and Welfare Funds.

Davis holds a Master’s degree in Public Administration from New York University, specializing in Health Services Management. He served on the Democratic Leadership Council’s Progressive Policy Institute Health Care Committee, and held positions on HIAA and AAHP committees, including chair of HIAA’s Managed Care Committee. A frequent guest speaker at industry events, Davis presents on a range of topics, including managed care, cost containment and marketing techniques.