- About CAQH CORE
- Operating Rules
- New Operating Rule Structure
- Eligibility & Benefits
- Claim Status
- Payment & Remittance
- Prior Authorization & Referrals
- Health Care Claims
- Benefit Enrollment
- Premium Payment
- Mandated Operating Rules
- CORE Certification
- Priority Topics
- Join CAQH CORE
- Resource Library
- CAQH ProView
- CAQH ProView for Groups
- CAQH ProView - Dental
- Provider Directory - DirectAssure
- Credentialing Solutions Suite
- COB Smart
Established in 2005, CAQH CORE is a multi-stakeholder collaboration of more than 120 organizations –providers, health plans, vendors, government agencies, and standard-setting bodies – developing...
The Committee on Operating Rules for Information Exchange (CORE) is a multi-stakeholder group committed to streamlining the business side of healthcare. Organized by CAQH, CORE is responsible for...
Mission Drive the creation and adoption of healthcare operating rules that support standards, accelerate interoperability, and align administrative and clinical activities among providers, payers...
The CAQH CORE Payment & Remittance Operating Rule Set addresses a range of operating rule requirements for the HIPAA-mandated EFT and ERA transactions including streamlining provider enrollment...
The CAQH CORE Claim Status Operating Rules enhance the exchange of claim status information between health plans and provider through consistent infrastructure including requirements that allow...
The CAQH CORE Eligibility & Benefits Operating Rules enhance the exchange of eligibility information between health plans and provider through consistent infrastructure and data content...
Keeping Up with the CORE-required Maximum Enrollment Data Sets If you are tasked with implementing the EFT & ERA Enrollment Data Rules, part of the Affordable Care Act (ACA)-mandated CAQH CORE...
Overview CAQH CORE certifies and awards CORE Certification Seals to entities and products/services that create, transmit or use the administrative transactions addressed by the CAQH CORE Operating...
Operating Rules Status | CAQH CORE EFT & ERA Operating Rules | Key Dates Coordination with Financial Services Industry | Medicare Implementation | Role of CAQH CORE Getting Involved...
CAQH awards CORE Certification Seals to entities that create, transmit or use the healthcare administrative and financial transactions addressed by the CAQH CORE Operating Rules. CORE Certification...