For Non-CORE Participants: ACA-Mandated Draft Phase IV CAQH CORE Operating Rules Preview


February 23, 2015 | 02:00 PM EST

Do you exchange claim transactions? Are you compliant with the existing Federally mandated operating rules? Over the past year, the CORE participants have been working on drafting the remaining Operating Rules mandated by the Affordable Care Act (ACA). The finalization of these rules will occur over the coming months. As a non- CORE participant, you can still engage on this ACA-driven work. Get a quick preview of the work already done, and the work currently underway, and how you can still contribute to their development.

In this session, non-CORE participants will get a brief and insightful look at what you can expect from the draft Phase IV CAQH CORE Operating Rules related to Premium Payment & Enrollment/Disenrollment and Claims & Prior Authorization.

  • Learn how operating rules are developed, based upon the established and stakeholder-inclusive CAQH CORE operating rule development process, and key next steps.
  • Discover why operating rules are important to and will affect YOUR BUSINESS.
  • Find out how you can still easily be involved in CAQH CORE operating rule development EVEN IF YOU ARE NOT A CORE PARTICIPANT, and how you can make a difference.
  • Get your questions answered, such as typical regulatory steps related to the rules.

This webinar is designed for non-CORE participating organizations and specifically all HIPAA-covered entities to which the Federally-mandated operating rules apply: Hospitals, providers, health plans, vendors and clearinghouses. Departments that would find it useful include: Compliance, IT Claim Operations and Process Improvement.

CAQH Program: