Public

Current Initiatives for CAQH CORE Participants

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 Roster Operating Rules

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.

CAQH CORE Town Hall

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.

Prior Authorization Automation Case Study Webinar with Cleveland Clinic, PriorAuthNow and CAQH CORE

CAQH CORE, together with Cleveland Clinic and PriorAuthNow (PAN), is pleased to share initial findings highlighting the impact of greater prior authorization (PA) automation and workflow integration leveraging standards and operating rules at Cleveland Clinic. The Cleveland Clinic will share how the implementation of an integrated PA solution is improving the ability of staff to conduct PAs and creating a more efficient process.