- About CAQH CORE
- Operating Rules
- New Operating Rule Structure
- Eligibility & Benefits
- Claim Status
- Payment & Remittance
- Prior Authorization & Referrals
- Health Care Claims
- Benefit Enrollment
- Premium Payment
- Mandated Operating Rules
- CORE Certification
- Priority Topics
- Join CAQH CORE
- Resource Library
- CAQH ProView
- CAQH ProView for Groups
- CAQH ProView - Dental
- Provider Directory - DirectAssure
- Credentialing Solutions Suite
- COB Smart
Join CAQH CORE: Benefits of Being a CAQH CORE Participant
The Committee on Operating Rules for Information Exchange (CORE) is a multi-stakeholder group committed to streamlining the business side of healthcare. Organized by CAQH, CORE is responsible for developing operating rules that improve the exchange of administrative data transactions.
To ensure the success of this industry-wide effort, it is critical to engage stakeholders throughout the healthcare system. By participating, organizations can have a direct impact in development of operating rules to reduce administrative burden.
Our model continues to be guided by industry, for industry, and our Participating Organizations play a critical role in shaping the healthcare landscape and setting future direction.
Impact of CAQH CORE Participants
- Lead development of new operating rules that remove unnecessary cost and complexity from the healthcare system. CAQH CORE Participating Organizations provide expertise and support throughout the development of all operating rules.
- Influence the direction of health IT policy through participation in CAQH CORE work groups, public forums and industry commentaries. Active participation in work groups and voting privileges give Participating Organizations a voice in industry decisions that impact your business. All work groups are open to and chaired by CAQH CORE Participants.
- Ensure that operating rules continue to meet evolving business needs by contributing to the maintenance of existing operating rules.
- Remain up to date with exclusive, participant-only content about industry developments, upcoming regulations and real-world case studies.
- Provide guidance to track implementation and ensure rules provide ROI across the industry.
- Engage with decision makers and influencers across the industry.