Organizations that can obtain the CAQH CORE Phase IV Certification Seal are categorized into four CORE Certification stakeholder types: Providers, Health Plans, Clearinghouses, and Vendors.
Section 2.2.5 of the Phase IV CAQH CORE Voluntary Certification Test Suite includes examples of organizations that can obtain the Phase IV CAQH CORE Certification Seal. The Phase IV CAQH CORE Voluntary Certification Test Suite also provides guidance as to the type of stakeholders to which the Phase IV CAQH CORE Operating Rules apply and how to determine when a specific rule’s detailed test script applies to a stakeholder. For a brief overview, please also see the slides from the Phase IV Certification webinar.
NOTE: While three of the four CORE Certification stakeholder types share names with HIPAA-covered entities – Health Plans, Providers, and Clearinghouses – for purposes of voluntary CORE Certification, these three CORE Certification stakeholder types encompass a broader group of organizations than what is included in their respective HIPAA definitions.