My organization is interested in pursuing CORE Certification, but a testing task in the CAQH CORE Certification Test Suite does not apply to my organization or its line of business. What do I do?

In the CORE Certification Testing Site, create and submit a rationale statement regarding why the specific testing task does not apply to your organization/line of business. For instructions on how to create and submit an issue, check the CORE Certification Testing Quick Start Guides.

This rationale statement should clearly justify why the testing task or its associated operating rule requirements do not apply to your organization, your line of business, or how your organization conducts the transaction.

In order to become CORE-certified for any CAQH CORE Operating Rule set, an organization or product has to undergo CORE Certification Testing. Where do I go for CORE Certification Testing?

CORE Certification is conducted by CORE CAQH CORE-authorized Testing Vendors. The test sites of these authorized testing vendors use a CORE Participant approved set of test script and the site was beta tested by CORE participants.   Currently, there is only one CORE-authorized testing entity: Edifecs. Start here to register for Edifecs CORE Certification Testing on all CAQH CORE Operating Rule sets. 

When a provider does not wish to load test information into their system (e.g., the provider names, etc.) as shown in the CAQH CORE Master Test Bed Data, can valid information about their organization be used instead when generating the required X12 270?

Yes, a provider should have no difficulty substituting currently valid data such as their own provider name, address information, including identifiers into the 270 documents submitted to a CAQH CORE-authorized testing vendor for CORE Certification testing. Some of the Eligibility & Benefits CAQH CORE Master Test Bed Data element values can be modified. These modifiable data elements and how they may be modified are specified in the CAQH CORE Master Test Bed Data for Eligibility & Benefits CORE Certification testing.

Once I have tested with the CAQH CORE-authorized Testing Vendor, what do I do with my successful CAQH CORE Certification Testing results?

The CORE Certification testing results provided to you by the CAQH CORE-authorized testing vendor are required to apply for a CORE Certification Seal. When your organization has successfully completed CORE Certification testing, submit the results to CAQH CORE, along with other required documentation, when applying for the CORE Certification Seal. Please see the CORE Certification Seal Application Form for more information.