The Payment & Remittance Operating Rules address requirements associated with electronic funds transfers and electronic remittance advice and establishes consistent use of claim adjustment and denial codes. A set of these rules is federally mandated—more information on all CAQH CORE federally mandated rules can be found here.
Complete Set of Payment & Remittance Operating Rules
CAQH CORE Payment & Remittance (835) Infrastructure Rule vPR2.0
CAQH CORE Payment & Remittance Uniform Use of CARCs and RARCs (835) Rule vPR.1.1
CAQH CORE Payment & Remittance (CCD+/835) Reassociation Rule vPR.1.0
CAQH CORE Payment & Remittance EFT Enrollment Data Rule vPR.1.0
• Excel Copy of the CORE-required Maximum EFT Enrollment Data Set
CAQH CORE Payment & Remittance ERA Enrollment Data Rule vPR.1.0
• Excel Copy of the CORE-required Maximum ERA Enrollment Data Set
- 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 Prior Authorization & Referrals 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.