Will the CAQH CORE Attachments Claims Infrastructure Rule require providers to use the X12 275 transaction to send attachments to support a claim submission?

Why was the X12 v5010 chosen for Claims Transactions when the rule supports v6020 of the Attachments transaction?

Since v5010X217 278 is currently specified in the CAQH CORE Prior Authorization Operating Rules and is the HIPAA-mandated version, the Attachments Subgroup – Prior Authorization Use Case voted, using a consensus-driven approach including straw polls, feedback forms, and discussions, to support X12 v5010 278 for consistency across existing CAQH CORE Operating Rules.

How will compliance regarding Attachments Claims Operating Rules be enforced?

In 2022, the Attachments Claims Operating Rules were published to industry for voluntary adoption. If an organization decides to pursue voluntary CORE Certification on the CAQH CORE Attachments Operating Rules, they have a maximum timeframe of 180 days to complete certification testing on the rule requirement after submission of the CAQH CORE Pledge to adopt the rule. CORE-certified entities are then required to recertify every three years.