Certification: ACA Section 1104 Certification, CORE Certification, Proposed CORE HIPAA Credential, and CORE Endorsement

II. Introduction to CORE Certification

C. CORE Certification: Testing

iii. Phase II CORE Certification Testing

1. Does the Phase II CAQH CORE Certification Master Test Suite have to be used for certification on all Phase II CAQH CORE Operating Rules?

Yes, the Phase II CORE Certification Master Test Suite addresses each rule in the Phase II CAQH CORE Operating Rules set. The CORE Certification Master Test Suite is used in order to maintain uniform testing processes and results and to gauge CAQH CORE Operating Rules conformance.

2. Where can my organization obtain the test data required for Phase II CORE Certification?

The Phase II CAQH CORE Master Test Bed Data is available on the CAQH website.

3. Is the Phase II CAQH CORE Master Test Bed Data different than the Phase I data?

The Phase II CAQH CORE Master Test Bed Data includes all of the Phase I CAQH CORE Master Test Bed Data along with additional data necessary for appropriate testing of the Phase II CAQH CORE 260: Data Content (X12 270/271) Rule.

Both Phase I and Phase II CAQH CORE Master Test Bed Data are available in an Excel spreadsheet format. The Phase I and Phase II CAQH CORE Master Test Bed Data are available on the CAQH website as two separate files.

4. In terms of modifying data, are there allowable exceptions for loading the Phase II CAQH CORE Master Test Bed Data? 

Yes, the exceptions are the same as for the Phase I CAQH CORE Master Test Bed Data. Allowable exceptions relate to the modification or non-use of some of the test data elements. In general, CORE Certification testers are not permitted to modify dates and patient demographic data. The Phase II CAQH CORE Master Test Bed Data also includes deductible and co-pay amounts explicitly shown as zero (0$) dollar amounts that are NOT modifiable.

Refer to the Phase II CAQH CORE Certification Testing Suite Version 2.1.0 Appendix for the specific data elements which can be modified and detailed instructions on use and loading of CAQH CORE Master Test Bed Data.

5. My organization is conducting concurrent Phase I and Phase II CAQH CORE Certification testing. Can I load all 32 Master Test Bed members as subscribers?

Yes. Refer to the Phase II CAQH CORE Certification Testing Suite Version 2.1.0 Appendix for detailed instructions on use and loading of the CAQH CORE Master Test Bed Data.