CAQH CORE Health Care Claims Operating Rules

The Health Care Claim Operating Rules streamline and standardize the exchange of information related to the submission, acknowledgment, and adjudication of healthcare claims, including attachments sent to support a claim submission.  

Complete Set of Health Care Claim Operating Rules

CAQH CORE Health Care Claim (837) Infrastructure Rule vHC.2.0

CAQH CORE Attachments Health Care Claims Infrastructure Rule vHC1.0

CAQH CORE Attachments Health Care Claims Data Content Rule vHC1.0

Additional Resources

  • CAQH CORE Connectivity: Visit the CAQH CORE Connectivity webpage for more information on which version of CAQH CORE Connectivity is required for implementation with these rules.
  • CORE Certification/Endorsement: Learn more about CORE Certification and CORE Endorsement for the Health Care Claim Operating Rules by visiting the CORE Certification webpage.
  • Resource Library: Visit the Resource Library to access FAQs, Analysis & Planning Guides, the CAQH CORE Master Companion Guide, webinars, and more to support implementation of the CAQH CORE Operating Rules.

For more information about the Operating Rules process or CORE Certification, contact CAQH CORE at CORE@caqh.org.

Type
Audience
Organization Type
CAQH Program