Organizations that can obtain the Prior Authorization & Referrals CORE Certification Seal are categorized into four CORE Certification stakeholder types: Providers, Health Plans, Clearinghouses, and Vendors.
The Prior Authorization & Referrals CAQH CORE Certification Test Suite includes examples of organizations that can obtain the Prior Authorization CORE Certification Seal. The Prior Authorization & Referrals CAQH CORE Certification Test Suite also provides guidance as to the type of stakeholders to which the CAQH CORE Prior Authorization & Referrals Operating Rules apply and how to determine when a specific rule’s detailed test script applies to a stakeholder.