Once certified, CORE-certified entities must remain conformant with applicable CAQH CORE Operating Rules throughout any system upgrades. An entity’s CORE Certification Seal will remain valid for three years, based off the year the certification was awarded. After three years, entities are required to complete the recertification process to renew its CORE Certification Seal.
Further, A CORE-certified entity may become de-certified and have their CORE Certification Seal revoked if instances of non-conformance are found and not remedied or if there is a 180-day lapse in renewing certification.
In instances of mergers, acquisitions, or deployment of new systems:
- If a CORE-certified entity is acquired by an entity that is not CORE-certified, the newly merged company will only be allowed to be CORE-certified if the acquired company is the only business that is applicable to the CAQH CORE Operating Rules. If this is not the case, then the newly merged company will be required to seek certification.
- If a CORE-certified entity acquires or develops new system(s) that are not CORE-certified, the CORE-certified entity will have 12 months to certify the new system(s); if the CORE-certified entity does not certify the new system(s), it will lose its CORE Certification Seal.