The CAQH CORE Master Companion Guide Template was updated to align with evolving needs of industry and newest published versions of the HIPAA-Mandated X12 standards. As such, the CAQH CORE Master Companion Guide template was updated to remove references to a specific version of the ASC X12 standard from the template. implementation of the CAQH CORE Master Companion Guide Template would be considered conformance with the CAQH CORE Attachments Claims Infrastructure Rule requirement Section 4., Companion Guide for X12 275 Attachments requirements.

No. There is no timing requirement set by this rule. However, this may be considered in future rule updates as implementation and use of the X12 v6020 or future versions of the X12 824 become more widely used within the industry.

When an X12 6020X316 275 is submitted, it goes through several layers of error handling, from HTTP to Payload Processing Layer, to Initial Data Content Processing Layer.

If no errors are encountered at a layer, the submission is passed to the next processing layer. Upon passing the Payload Processing Layer, an X12 999 FA is sent to acknowledge acceptance. Once the Initial Data Content Processing Layer processes the content of the payload, the receiver (server) must return an X12 v6020X257 824 to report acceptance or any errors in the payload.

The X12 v6020 824 provides error messages at the data content level, which one layer deeper, than X12 v5010 999. The X12 v5010 999 returns an acknowledgement at the application layer (payload processing). The X12 v6020 824 can also provide more information on errors that delay adjudication (e.g., front end edits that can be used to inform the submitter that the transaction will fail adjudication at the next level of processing; for example, invalid patient ID).

The usage of X12 v6020 824 is independent from other X12 responses, such as the X12 v5010 278 Response and X12 v6020 999.

Yes. Attachments sent to support Health Care Claim submissions require Batch Processing with optional support for Real Time Processing.

Both the X12 and non-X12 methods address usage patterns for Real Time and Batch Processing Modes, including the use of SOAP and REST. Both methods address the exchange of security identifiers, and communications-level errors and acknowledgements and do not attempt to define the specific content of the message payload beyond declaring the formats that must be used between entities and that security information must be sent outside of the message envelop payload. 

No. Adoption of these rules is currently voluntary and as such can be used between willing trading partners.

The CAQH CORE Connectivity Rule vC4.0.0 includes requirements for the exchange of messages using both SOAP and REST. The CAQH CORE Connectivity Rule vC4.0.0 also includes support for the X12 v6020X316 275 attachments transaction in the scope of the rule, meaning that the rule applies when trading partners exchange the X12 v6020X316 275.

Since February 2022, all CAQH CORE Infrastructure Operating Rules including CAQH CORE Attachments Claims Infrastructure Rule require use of the most current CAQH CORE published and adopted version of the CAQH CORE Connectivity Rule” (please see the CAQH CORE Connectivity web page to find the most recent published and adopted version of the CAQH CORE Connectivity Rule).