Current Initiatives for CAQH CORE Participants

CAQH CORE Participating Organizations help ensure that operating rules continue to meet evolving business needs, by engaging in the rule development process and maintenance of existing operating rules. Workgroups are open to all CAQH CORE Participating Organizations, and multiple individuals from the same Participating Organization may join. Because each organization has only one vote, participants collaborate with their colleagues to submit an organizational-level response during voting periods.

Below is a list of CAQH CORE workgroups that currently convene or are upcoming. In addition to contributing to these workgroups and the formal CAQH CORE voting process, Participating Organizations benefit from exclusive education content and research opportunities. If you would like to join any of the following groups please contact core@caqh.org.

Initiative	Focus	Current Objectives	Status
Rules Work Group	Rule Review	Reviews and ballots draft operating rules developed by the Subgroups prior to an All CAQH CORE Participant Vote. Currently reviewing the Draft Phase V CAQH CORE Prior Authorization Operating Rules developed by the Prior Authorization Subgroup.	Active
Certification & Testing Subgroup	Test Suite Development	Develops the Certification Test Suites for draft operating rules. Currently developing the test suite for the Draft Phase V CAQH CORE Prior Authorization Operating Rules.	Active
Technical Work Group	Test Suite / Technical Specification Review	Reviews and ballots draft technical operating rules and test suites developed by the Subgroups prior to an All CAQH CORE Participant Vote.	Upcoming
CORE Code Combinations Task Group	Rule Maintenance	Maintains the CORE Code Combinations in the Phase III CAQH CORE Uniform Use of CARCs and RARCs Rule.	Active
Enrollment Data Task Group	Rule Maintenance	Maintains the CORE-required Maximum EFT & ERA Enrollment Data Sets in the Phase III CAQH CORE EFT & ERA Enrollment Data Rules.	Upcoming

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Contact CAQH CORE

Questions or requests for CAQH CORE? Email:

core@caqh.org

CAQH CORE Participant Calendar

Mandated Operating Rules

View the Mandated Operating Rules Timeline

CORE Event Listing

1/31/19

CAQH CORE Town Hall National Webinar - CAQH CORE will update the audience on its efforts to deliver administrative efficiency and value to the healthcare industry for the benefit of patients, providers and health plans.

2/25/19

14th National Value-based Payment and Pay for Performance Summit - April Todd, SVP of CAQH CORE and Explorations, will present "All Together Now: Applying the Lessons of Fee-for-Service to Streamline Adoption of Value-based

2/26/19

12th Healthcare Payments Innovations - CAQH CORE Director Erin Richter-Weber will present "Exclusive CAQH CORE Study Results" on February 26th at 9:00 a.m.

3/4/19

28th National HIPAA Summit - CAQH CORE Director Erin Weber will present "Improving the HIPAA Transactions: An Update on ACA Operating Rules" on March 6th at 9:00 a.m.

4/14/19

MGMA19 | The Operations Conference - CAQH CORE Director Erin Richter-Weber will present "Applying the Lessons of Fee-for-Service to Streamline Adoption of Value-based Payments" on April 15th at 1:30 p.m.

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