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Keeping Up with the CORE-required Maximum Enrollment Data Sets If you are tasked with implementing the CAQH CORE 380: EFT Enrollment Data Rule and the CAQH CORE 382: ERA Enrollment Data Rule, part...
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...
Operating Rules Status | Immediate Action Required | Key Dates | Role of CAQH CORE | Getting Involved with CAQH CORE | Education and Outreach | Implementation Resources | ...
A CAQH study, conducted by IBM Global Business Services, assessed results achieved by six CORE-certified health plans that represent 33 million covered lives (Aetna, AultCare, BlueCross BlueShield of...
The Patient Protection and Affordable Care Act (ACA), Section 1104 “…establishes new requirements for administrative transactions that will improve the utility of the existing HIPAA transactions and...
Industry-led, CAQH CORE Participants include healthcare providers, health plans, vendors, government entities, associations and standard-setting organizations. Health plans participating in CAQH...
In 2013, CAQH CORE extended its existing multi-stakeholder governance and, in 2015, updated its governing procedures, which can be accessed here. Presented below is the multi-stakeholder CAQH CORE...
CAQH CORE Body* CAQH CORE Requirements for Rules Approval Level 1: CAQH CORE Subgroups Not addressed in governing procedures, but must occur to ensure consensus building...