The Committee on Operating Rules for Information Exchange (CORE) is a multi-stakeholder initiative of CAQH. CAQH CORE was established in 2005 with the mission to build consensus among healthcare industry stakeholders on a set of operating rules that facilitate administrative interoperability between providers and health plans.
Since its inception, CAQH CORE has been structured around a model that operating rules authoring entities should take the responsibility of going above and beyond authorship to help drive adoption. To do this, CAQH CORE applies an integrated model in which CAQH CORE:
- Develops operating rules through broad-based stakeholder input that supports using standards.
- Develops and offers a certification program that ensures operating rules are objectively and rigorously tested and, thus, there is a solid base of early implementers.
- Builds broad-based awareness of the operating rules.
- Provides in-depth, detailed technical knowledge and assistance through early adopters.
- Promotes operating rules adoption by a majority of all stakeholders.
- Tracks industry progress on adoption and return on investment (ROI).
- Maintains the operating rules as business needs change.
- Provides regular status updates to the industry and Federal oversight committees and agencies.
The CAQH CORE Integrated Model