CAQH CORE Participating Organizations help ensure that operating rules continue to meet evolving business needs, by engaging in the rule development process and maintenance of existing operating rules. Work groups are open to all CAQH CORE Participating Organizations, and multiple individuals from the same Participating Organization may join. Because each organization has only one vote, participants collaborate with their colleagues to submit an organizational-level response during voting periods.
Attributed Patient Rosters are used by health plans, providers and employers to share lists of patients attributed to a provider under a value-based contract. The CAQH CORE Attributed Patient Roster Operating Rules establish consistent expectations for the electronic exchange of attributed patient rosters among stakeholders at predictable intervals by supporting consistent data content, infrastructure and a connectivity safe harbor using the X12 005010X318 Member Plan Reporting (834) Transaction.
The CAQH CORE Eligibility & Benefits Operating Rules enhance the exchange of eligibility information between health plans and provider through consistent infrastructure and data content requirements including the exchange of patient financial information.
CAQH CORE has updated its operating rule structure. The CAQH CORE FAQs are in the process of being updated to align with the new structure. CAQH CORE appreciates your patience as these updates are made.
CAQH CORE has produced a variety of online resources to provide education on operating rule implementation and CAQH CORE initiatives.
CAQH CORE has developed interactive tools and dashboards on topics of interest to industry stakeholders.
CAQH CORE will provide an update of its work efforts and priority initiatives for 2021 to deliver administrative efficiency and value to the healthcare industry. Topics will include:
Industry-led, CAQH CORE Participants include healthcare providers, health plans, vendors, government entities, associations and standard-setting organizations. Health plans participating in CAQH CORE represent 75 percent of the insured US population. We are working in collaboration to simplify administrative data exchange. Join us and become a CAQH CORE Participant today!
CAQH CORE will provide an update of its work efforts and priority initiatives to deliver administrative efficiency and value to the healthcare industry.
Register for this Town Hall to engage with CAQH CORE and provide input on how to best drive the industry towards fully digital business operations. For any questions, please contact CAQH CORE staff at CORE@caqh.org.
Starting in 2021, CORE-certified entities will be required to renew their CORE Certifications every three years on a rolling basis. Register for this webinar to understand how to assess ongoing conformance with the operating rules through CORE Recertification. Webinar highlights will include:
Plan to Cast Your Vote by Friday, December 4th: The CAQH CORE Connectivity & Security Work Group recently passed a ballot approving the draft CAQH CORE connectivity rule and the CAQH CORE Review Work Group approved a set of draft value-based payments rules focused on patient attribution. The next step in the CAQH CORE voting process is the Final Vote which opens on November 16th and closes on December 4th.