Past CAQH CORE Events

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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:
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Plan to Cast Your Vote by Friday, December 4th: The CAQH CORE Connectivity & Security Work Group recently passed a ballot approving the draft CAQH CORE connectivity rule and the CAQH CORE Review Work Group approved a set of draft value-based payments rules focused on patient attribution. The next step in the CAQH CORE voting process is the Final Vote which opens on November 16th and closes on December 4th.
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In a collaboration between the Centers for Medicare and Medicaid Services (CMS), WEDI and CAQH CORE, the CMS National Standards Group will provide an overview of the HIPAA Standards Exceptions Request Process to allow organizations to request an exception from the use of a standard from the HHS Secretary to test a proposed modification to that standard.
Following the presentation, time will be allocated for Q&A, with questions submitted prior to the webinar. Please submit your questions during the webinar registration process.
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CAQH CORE will provide an update of its 2020 Goals and priority initiatives to deliver administrative efficiency and value to the healthcare industry. Topics will include:
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CAQH CORE, together with Cleveland Clinic and PriorAuthNow (PAN), is pleased to share initial findings highlighting the impact of greater prior authorization (PA) automation and workflow integration leveraging standards and operating rules at Cleveland Clinic. The Cleveland Clinic will share how the implementation of an integrated PA solution is improving the ability of staff to conduct PAs and creating a more efficient process.
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Connectivity is essential for successful interoperability as it enables the transport of information to support data exchange. To address the industry’s need to align on a common set of communication protocols, CAQH CORE maintains a set of operating rules addressing connectivity and security of data exchange. CAQH CORE Participating Organizations are currently evaluating updates to the CAQH CORE Connectivity requirements to address existing and emerging standards and protocols to support the intersection of administrative and clinical data exchange.
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On June 23, CAQH CORE staff will host a panel discussion featuring CAQH CORE Board members centered on key industry topics, including value-based payments, interoperability, and COVID-19.

Speakers:

Dr. Sue Turney (MGMA) President and CEO, Marshfield Clinic Health System

Tim Kaja Chief Operating Officer of UnitedHealth Networks, UnitedHealthcare

Dr. Marilyn Heine (AMA) Clinical Assistant Professor of Medicine, Drexel University College of Medicine
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On May 20, CAQH staff will host a lunchtime panel discussion centered on key research topics, including the CAQH Index and the Prior Authorization Pilot & Measurement Initiative.

Panel highlights:

  • Discuss the upcoming 2020 Index data collection efforts and survey enhancements.
  • Learn about the Prior Authorization Pilot & Measurement Initiative to assess impact and close automation gaps in the prior authorization workflow.

Speakers:

  • Kristine Burnaska, CAQH Research and Measurement Director
  • Rachel Goldstein, CAQH CORE Senior Manager
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The ASC X12N Health Care Services Review – Request for Review and Response (278) is a paired transaction set. This transaction set is also known informally by other names, such as Referral or Prior Authorization. The 278 is used throughout the healthcare marketplace by providers to electronically submit prior authorization and referral requests. CAQH CORE Operating Rules for Prior Authorization help the industry effectively utilize the 278 transaction to further standardize and automate components of the prior authorization process.
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Join the CAQH CORE team for an update of current and ongoing initiatives to deliver administrative efficiency and value to the healthcare industry. Topics will include:   
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