Frequently Asked Questions - iv. Payment & Remittance CORE Certification Testing

Is CORE Certification available for the CAQH CORE Payment & Remittance Operating Rules?

Submitted by tfuchs@caqh.org on Tue, 03/01/2022 - 11:09
Is CORE Certification available for the CAQH CORE Payment & Remittance Operating Rules?

Yes. CORE Certification on the CAQH CORE Payment & Remittance Operating Rule set is available for entities that use, conduct, or process the applicable X12 v5010 835 and Healthcare EFT Standards transactions. All necessary and relevant documents for CORE Certification on Payment & Remittance Operating Rules are available on the CORE Certification webpage.

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What is the purpose of the Payment & Remittance CAQH CORE Certification Test Suite?

Submitted by tfuchs@caqh.org on Tue, 03/01/2022 - 11:09
What is the purpose of the Payment & Remittance CAQH CORE Certification Test Suite?

The Payment & Remittance CAQH CORE Certification Test Suite  defines specific certification testing requirements and detailed test scripts for each of the CAQH CORE Payment & Remittance Operating Rules to be completed by entities seeking CORE Certification. These detailed test scripts are not intended to exhaustively and comprehensively test all requirements of the Payment & Remittance Operating Rules; rather, they focus on a key subset of each rule’s requirements. CAQH CORE-authorized testing vendors use the scenarios and test scripts from the Payment & Remittance CAQH CORE Certification Test Suite in their CORE Certification testing products.

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Does the Payment & Remittance CAQH CORE Certification Test Suite have to be used for certification on all Payment & Remittance Operating Rules?

Submitted by tfuchs@caqh.org on Tue, 03/01/2022 - 11:10
Does the Payment & Remittance CAQH CORE Certification Test Suite have to be used for certification on all Payment & Remittance Operating Rules?

Yes, the Payment & Remittance CAQH CORE Certification Test Suite addresses each rule in the CAQH CORE Payment & Remittance Operating Rules set. The CORE Certification Test Suite is used in order to maintain uniform testing processes and results and to gauge CAQH CORE Operating Rules conformance across all CORE-certified organizations.

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Do the test scripts in the Payment & Remittance Master Test Suite address all of the CAQH CORE Payment & Remittance Operating Rules?

Submitted by tfuchs@caqh.org on Tue, 03/01/2022 - 11:10
Do the test scripts in the Payment & Remittance Master Test Suite address all of the CAQH CORE Payment & Remittance Operating Rules?

Yes, each CAQH CORE Payment & Remittance Operating Rule has its own set of CORE Certification test scripts in the Payment & Remittance CAQH CORE Certification Test Suite. However, CAQH CORE Certification Testing is not exhaustive. The CAQH CORE Certification Test Suites do not include comprehensive testing requirements that test for all possible permutations of each rule.

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Is there CORE Master Test Bed Data required for CORE Certification on the Payment & Remittance Operating Rules?

Submitted by tfuchs@caqh.org on Tue, 03/01/2022 - 11:11
Is there CORE Master Test Bed Data required for CORE Certification on the Payment & Remittance Operating Rules?

No. There is no Master Test Bed Data for CORE Certification on the CAQH CORE Payment & Remittance Operating Rules. All necessary documents to achieve CORE Certification on Payment & Remittance are available on the CORE Certification Step-by-Step Process webpage.

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