FAQ Categories
- Part A: ACA Section 1104 Mandate for Federal Operating Rules Expand Secondary Navigation Menu
- Part B: CAQH CORE Connectivity Expand Secondary Navigation Menu
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Part C: CAQH CORE Eligibility & Benefits Operating Rules
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- I. General CAQH CORE Eligibility & Benefits Operating Rules Questions
- II. CAQH CORE Eligibility & Benefits (270/271) Infrastructure Rule
- II. Interdependent CAQH CORE Eligibility & Benefit Requirements
- III. CAQH CORE 150: Batch Acknowledgements Rule
- III. CAQH CORE Eligibility & Benefits (270/271) Data Content Rule
- IV. CAQH CORE Eligibility & Benefits (270/271) Single Patient Attribution Data Rule
- IX. CAQH CORE 156: Real Time Response Time Rule
- V. CAQH CORE 152: Companion Guide Rule
- VI. CAQH CORE 153: Connectivity Rule
- VIII. CAQH CORE 155: Batch Response Time Rule
- X. CAQH CORE 157: System Availability Rule
- XI. CAQH CORE 250: Claim Status Infrastructure Rule
- XII. CAQH CORE 258: Normalizing Patient Last Name Rule
- XIII. CAQH CORE 259: AAA Error Code Reporting Rule
- XV. CAQH CORE 270: Connectivity Rule
- XVI. Resources for Implementing the CAQH CORE Eligibility & Claim Status Operating Rules
- Part D: CAQH CORE Claim Status Operating Rules
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Part E: CAQH CORE Payment & Remittance Operating Rules
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- I. General CAQH CORE Payment & Remittance Operating Rules
- II. CAQH CORE Payment & Remittance (835) Infrastructure Rule
- III. CAQH CORE Payment & Remittance Uniform Use of CARCs and RARCs (835) Rule
- IV. CAQH CORE Payment & Remittance Reassociation (CCD+/835) Rule
- V. CAQH CORE Payment & Remittance EFT Enrollment Data Rule
- VI. CAQH CORE Payment & Remittance ERA Enrollment Data Rule
- VII. Resources for Implementing the CAQH CORE Payment & Remittance Operating Rules
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Part F: CAQH CORE Prior Authorization & Referrals Operating Rules
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- I. General CAQH CORE Prior Authorizations & Referrals Operating Rule Questions
- II. CAQH CORE Prior Authorization & Referrals (278) Infrastructure Rule
- III. CAQH CORE Prior Authorization & Referrals (278) Data Content Rule
- IV. Web Portal CAQH CORE Prior Authorization & Referrals Web Portal Rule
- V. General CAQH CORE Attachments Prior Authorization Operating Rule Questions
- VI. CAQH CORE Attachments Prior Authorization Infrastructure Rule
- VII. CAQH CORE Attachments Prior Authorization Data Content Rule
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Part G: CAQH CORE Health Care Claims Operating Rules
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- I. General CAQH CORE Health Care Claims Operating Rules Questions
- II. CAQH CORE Health Care Claims (837) Infrastructure Rule
- III. General CAQH CORE Attachments Claims Operating Rule Questions
- IV. CAQH CORE Attachments Claims Infrastructure Rule Questions
- V. CAQH CORE Attachments Claims Data Content Rule Questions
- Part H: CAQH CORE Benefit Enrollment Operating Rules Expand Secondary Navigation Menu
- Part I: CAQH CORE Premium Payment Operating Rules Expand Secondary Navigation Menu
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Part J: Certification: CORE Certification, CORE Recertification, and CORE Endorsement
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- I. Background on ACA Section 1104 Certification
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I. Introduction to CORE Certification
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- A. CORE Certification and Recertification: Overview Expand Secondary Navigation Menu
- B. CORE Certification: Stakeholder Specific Questions Expand Secondary Navigation Menu
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C. CORE Certification: Testing
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- i. CORE Certification Testing Overview
- ii. Eligibility & Benefits CORE Certification Testing
- iii. Claim Status CORE Certification Testing
- iv. Payment & Remittance CORE Certification Testing
- v. Prior Authorization & Referrals CORE Certification Testing
- vi. Health Care Claims CORE Certification Testing
- Vii. Benefit Enrollment CORE Certification Testing
- viii. Premium Payment CORE Certification Testing
- II. Introduction to CORE Endorsement
- III. Introduction to Proposed CORE HIPAA Credential
- III. Related Resources and Links