Health Care Claims Operating Rules

The CAQH CORE Health Care Claim Operating Rules support consistent infrastructure and a connectivity safe harbor across the industry.

Complete Set of CAQH CORE Health Care Claim Operating Rules

CAQH CORE Health Care Claim (837) Infrastructure Rule vHC.1.0

CAQH CORE Connectivity Rule vC3.1.0

        • XML Schema v3.1.0 

        • WSDL Schema v3.1.0 

        • CAQH CORE-Required Processing Mode Payload Type Tables

CORE Certification & Endorsement

CORE Certification for Health Care Claim is available to all entities that create, transmit or use health care claim transactions. Entities that do not use, create or transmit health care claims transactions can demonstrate their support for CAQH CORE’s mission and its operating rules through CORE Endorsement.

Implementation Resources

Visit the Implementation Resources webpage to access FAQs, Analysis & Planning Guides, 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.