The X12 005010X221A1 Health Care Claim Payment/Advice (835) TR3 Implementation Guide is the HIPAA-adopted standard for claim payment/advice. This guide provides standardized data content for creation and use of the 835 transaction. The 835 is used throughout the healthcare marketplace by providers to post claim payments and adjustments to their accounting systems. CAQH CORE Payment & Remittance Operating Rules help the industry more effectively implement and use the 835 transaction to understand payment decisions and optimize denial management.

The CORE Code Combinations organize claim denial and adjustment codes into unique business scenarios for more consistent code use across industry. CAQH CORE conducts a biennial Market-based Review (MBR) of the CORE Code Combinations to address industry business needs.

Join the CAQH CORE Team to learn more about new and updated CAQH CORE Operating Rules approved with overwhelming support in late 2020 for industry implementation, including:

CAQH CORE will provide an update of its work efforts and priority initiatives for 2021 to deliver administrative efficiency and value to the healthcare industry. Topics will include:

Starting in 2021, CORE-certified entities will be required to renew their CORE Certifications every three years on a rolling basis. Register for this webinar to understand how to assess ongoing conformance with the operating rules through CORE Recertification. Webinar highlights will include: