Frequently Asked Questions - VII. Resources for Implementing the Phase IV CAQH CORE Operating Rules

The CAQH CORE Implementation Resources webpage has a number of resources and tools available at no cost to assist entities with implementation of the Phase IV CAQH CORE Operating Rules including an Analysis & Planning Guide for Implementing the Phase IV CAQH CORE Operating Rules, frequent CAQH CORE Education Events, and more.

Voluntary CORE Certification for the Phase IV CAQH CORE Operating Rules is now available. Phase IV CORE Certification covers four healthcare business transactions: healthcare claims; prior authorization; employee premium payment; and enrollment and disenrollment in a health plan. Entities interested in pursuing Phase IV CORE Certification should review the Phase IV CAQH CORE Voluntary Certification Test Suite which documents the test scripts required for Phase IV CORE Certification.