CORE https://www.caqh.org/ en Price Transparency https://www.caqh.org/core/price-transparency <span>Price Transparency </span> <span><span lang="" about="/users/kcoopercaqhorg" typeof="schema:Person" property="schema:name" datatype="">kcooper@caqh.org</span></span> <span>Mon, 06/27/2022 - 13:33</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><h2>CAQH CORE: Establishing the Building Blocks of Price Transparency </h2> <p>The healthcare industry has seen several laws and regulations related to price transparency over the last years, including the Centers for Medicare &amp; Medicaid Services (CMS) Hospital Price Transparency Rule, CMS Transparency in Coverage Rule, the No Surprises Act, and related regulations. The purpose of these policies is to increase consumer awareness of the cost of care and limit surprise billing practices. </p> <p>The No Surprises Act, signed into law as part of the Consolidated Appropriations Act of 2021, addresses surprise medical billing at the federal level. Section 111 of the Act requires health plans to provide an Advanced Explanation of Benefits (EOB) for scheduled services at least three days in advance to give patients transparency into which providers are expected to provide treatment, the expected cost, and the network status of the providers. Additionally, Section 112 states that healthcare providers and facilities must verify, three days in advance of a service and no later than one day after scheduling a service, what type of coverage the patient is enrolled in and provide notification of a Good Faith Estimate of charges to the payer client. </p> <p><span><span><span>As new price transparency laws emerge, such as the No Surprises Act, the healthcare industry is presented with opportunities to coalesce around common approaches for exchanging data in a uniform way — resulting in lower costs and greater automation across stakeholders. In 2021, CAQH CORE launched the Advanced EOB Advisory Group to develop recommendations for standardized processes to meet the Advanced EOB requirements in the No Surprises Act without creating undue burden for patients, providers, and health plans. These consensus-based recommendations were published the guidance document, <a href="https://www.caqh.org/sites/default/files/CORE%20-%20Price%20Transparency%20Whitepaper_v4.pdf">Establishing the Building Blocks for Price Transparency: Industry Guidance on Provider to Payer Approaches for Good Faith Estimate Exchanges</a>, which highlight the messaging standards, connectivity protocols, and related data content identified by the Advanced EOB Advisory Group to support the exchange of Good Faith Estimates between providers and payers. </span></span></span></p> <p><span><span><span>Throughout 2022, CAQH CORE continues to engage in industry discussions, support business implementations, and educate stakeholders about the need for action and progress on these efforts through a series of focus groups and webinars centered on Good Faith Estimate and Advanced EOB requirements. CAQH CORE will use these discussions to assess additional use cases for recommendations and monitor the need and relevance to develop operating rules to support industry’s readiness to implement No Surprises Act requirements.</span></span></span></p> <p><span><span><span>For more information on how to get involved with the CAQH CORE Price Transparency Initiatives, email <a href="mailto:core@caqh.org">core@caqh.org</a>. </span></span></span></p> </div> <div class="field field--name-field-taxonomy-audience field--type-entity-reference field--label-inline"> <div class="field--label">Audience</div> <div class="field--item"><a href="/target-audience/public" hreflang="en">Public</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Mon, 27 Jun 2022 17:33:13 +0000 kcooper@caqh.org 3854 at https://www.caqh.org Price Transparency Series: Regulatory Landscape & Industry Progress https://www.caqh.org/about/event/price-transparency-series-regulatory-landscape-industry-progress <span>Price Transparency Series: Regulatory Landscape &amp; Industry Progress</span> <span><span lang="" about="/users/dasteriadiscaqhorg" typeof="schema:Person" property="schema:name" datatype="">dasteriadis@caqh.org</span></span> <span>Tue, 06/14/2022 - 15:22</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2022-06-23T17:00:00Z">June 23, 2022 | 01:00 PM EDT</time> - <time datetime="2022-06-23T18:00:00Z">June 23, 2022 | 02:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><table align="center" border="0" cellpadding="0" cellspacing="0" width="100%"><tbody><tr><td> <p>Join CAQH CORE for an update on continued efforts to support industry implementation of price transparency regulations, including the Advanced Explanation of Benefits (EOB) requirements in the No Surprises Act (NSA). In May, CAQH CORE convened an industry Focus Group to discuss preparations to meet these NSA requirements.</p> <p>In the first installment of this webinar series, CAQH CORE staff will be joined by Co-Chairs from WEDI’s NSA Task Group for a conversation about industry readiness and progress using polling results from the Focus Group and WEDI NSA Survey findings as a guide.</p> <p>What will you learn by registering for this webinar?</p> <ul><li> <p>Get an update on the latest regulatory information and industry efforts related to Advanced EOB.</p> </li> <li> <p>Hear insights from the first CAQH CORE Focus Group including organizations’ implementation status, guidance on best practices, and approaches to overcome key barriers.</p> </li> <li> <p>Learn about WEDI’s NSA efforts including highlights from a recent industry survey.</p> </li> </ul><p><strong>Speakers</strong></p> <p>Beth Davis, Allscripts, Senior Manager of Operations</p> <p>Stanley Nachimson, Consultant, Cooperative Exchange</p> <p>Rob Tennant, WEDI, Vice President of Federal Affairs</p> <p>Erin Weber, CAQH CORE, Vice President</p> <p><strong>For any questions, please contact CAQH CORE staff at <a href="mailto:core@caqh.org" target="_blank">education@caqh.org.</a></strong></p> </td> </tr></tbody></table></div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/price-transparency-series-regulatory-landscape-industry-progress" data-a2a-title="Price Transparency Series: Regulatory Landscape &amp; Industry Progress"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-resource-list field--type-file field--label-hidden field--items"> <div class="field--item"><span class="file file--mime-application-pdf file--application-pdf icon-before"><span class="file-icon"><span class="icon glyphicon glyphicon-file text-primary" aria-hidden="true"></span></span><span class="file-link"><a href="https://www.caqh.org/sites/default/files/core/events/CAQH-CORE-No-Surprises-Act-Industry-Readiness-Webinar-Slides.pdf" type="application/pdf; length=1467852" title="Open file in new window" target="_blank" data-toggle="tooltip" data-placement="bottom">CAQH-CORE-No-Surprises-Act-Industry-Readiness-Webinar-Slides.pdf</a></span><span class="file-size">1.4 MB</span></span></div> <div class="field--item"><a href="https://www.youtube.com/watch?v=fJx-1b2nFZA" target="_blank" class="field-resource-list-remote-video last" hreflang="en">Price Transparency Series: No Surprises Act Regulatory Landscape &amp; Industry Readiness for AEOB</a></div> </div> <div class="field field--name-field-resource-list-remote-video field--type-entity-reference field--label-hidden field--items"> <div class="field--item"><a href="/media/253/edit" hreflang="en">Price Transparency Series: No Surprises Act Regulatory Landscape &amp; Industry Readiness for AEOB</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Tue, 14 Jun 2022 19:22:50 +0000 dasteriadis@caqh.org 3853 at https://www.caqh.org WEDI Spring Conference https://www.caqh.org/about/event/wedi-spring-conference <span>WEDI Spring Conference</span> <span><span lang="" about="/users/dasteriadiscaqhorg" typeof="schema:Person" property="schema:name" datatype="">dasteriadis@caqh.org</span></span> <span>Tue, 05/17/2022 - 12:41</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Conference</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2022-05-23T13:00:00Z">May 23, 2022 | 09:00 AM EDT</time> - <time datetime="2022-05-26T21:00:00Z">May 26, 2022 | 05:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>CAQH CORE will presenting alongside other industry speakers on May 26th from 2:15-4:15pm ET.</p> <p>This year's virtual conference will focus on leveraging technology to help solve the biggest issues in health care. Sessions will focus on several healthcare topics including:</p> <ul fr-original-style=""><li>Regulations/ Patient Enablement</li> <li>Clinical Exchange</li> <li>Administrative Efficiency</li> <li>Automation</li> <li>Health Equity</li> <li>Privacy &amp; Security</li> </ul><p> </p> </div> <div class="field field--name-field-registration-link field--type-link field--label-hidden field--item"><a href="https://members.wedi.org/event-calendar/Details/wedi-2022-spring-conference-virtual-568962?sourceTypeId=Website">Register Now</a></div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/wedi-spring-conference" data-a2a-title="WEDI Spring Conference"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Tue, 17 May 2022 16:41:27 +0000 dasteriadis@caqh.org 3843 at https://www.caqh.org Eligibility & Benefits Standards and Operating Rules https://www.caqh.org/about/event/eligibility-benefits-standards-and-operating-rules <span>Eligibility &amp; Benefits Standards and Operating Rules</span> <span><span lang="" about="/users/dasteriadiscaqhorg" typeof="schema:Person" property="schema:name" datatype="">dasteriadis@caqh.org</span></span> <span>Tue, 05/17/2022 - 12:39</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2022-07-11T17:00:00Z">July 11, 2022 | 01:00 PM EDT</time> - <time datetime="2022-07-11T18:00:00Z">July 11, 2022 | 02:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>The Health Care Eligibility Benefit Inquiry and Response and the associated X12 Technical Report Type 3 Implementation Guides provide the HIPAA-adopted standards for healthcare eligibility and benefit inquiries. These guides provide standardized data content for creation and use of the v5010 270/271 transaction. The 270 transaction set is used throughout the healthcare marketplace to transmit healthcare eligibility and benefit inquiries from health care providers, insurers, clearinghouses and other healthcare adjudication processors. Meanwhile, the 271 transaction set is the appropriate response mechanism for healthcare eligibility and benefit inquiries. The federally mandated CAQH CORE Eligibility &amp; Benefits Operating Rules align with these transactions and help the industry more effectively implement and use the 270/271 transactions to determine a patient’s eligibility and benefits.</p> <p>Tune in on July 11<sup>th</sup> for a new installment of an ongoing webinar series with the standard development organization, X12, and HHS-designated operating rule author, CAQH CORE.</p> <p><strong>What will you learn by registering for this webinar?</strong></p> <ul><li>An overview of the X12N 270/271 standard transaction.</li> <li>A review of the benefits of using the 270/271 transaction to communicate eligibility and benefits information, which saves providers both time and money.</li> <li>An in-depth analysis of how the CAQH CORE Eligibility &amp; Benefits Operating Rules work in concert with the 270/271 transaction to automate electronic eligibility and benefits inquiry processes and reduce the cost of today’s more manual processes more fully.</li> </ul><p>To view the other webinars in our educational series, please click <a href="https://www.youtube.com/watch?v=liarT1scUW0&amp;list=PLGulir3D2LZSjqI2vTFMyPb_SnN4Z2sJA" target="_top">here</a>.</p> <p><b>Speakers:</b></p> <ul><li>Donna Campbell, Provider Portal and Provider Connectivity Manager, BCBS Illinois</li> <li>Evert Ford, Product Manager, Optum</li> <li>Erin Weber, Vice President, CAQH CORE</li> </ul></div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/eligibility-benefits-standards-and-operating-rules" data-a2a-title="Eligibility &amp; Benefits Standards and Operating Rules"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-resource-list field--type-file field--label-hidden field--items"> <div class="field--item"><span class="file file--mime-application-pdf file--application-pdf icon-before"><span class="file-icon"><span class="icon glyphicon glyphicon-file text-primary" aria-hidden="true"></span></span><span class="file-link"><a href="https://www.caqh.org/sites/default/files/core/events/CAQH%20CORE%20and%20X12%20Webinar%20Series%20270%20Eligibility%20Slides%20FINAL.pdf" type="application/pdf; length=2207646" title="Open file in new window" target="_blank" data-toggle="tooltip" data-placement="bottom">CAQH-CORE-and-X12-Webinar-Series-Intro-270-271-Eligibility-Slides.pdf</a></span><span class="file-size">2.11 MB</span></span></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Tue, 17 May 2022 16:39:50 +0000 dasteriadis@caqh.org 3842 at https://www.caqh.org Electronic Payment Impact on Dental Practice Financials https://www.caqh.org/about/event/electronic-payment-impact-dental-practice-financials <span>Electronic Payment Impact on Dental Practice Financials</span> <span><span lang="" about="/users/dasteriadiscaqhorg" typeof="schema:Person" property="schema:name" datatype="">dasteriadis@caqh.org</span></span> <span>Tue, 05/17/2022 - 12:26</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2022-06-08T17:00:00Z">June 08, 2022 | 01:00 PM EDT</time> - <time datetime="2022-06-08T18:00:00Z">June 08, 2022 | 02:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Join CAQH CORE and Nacha for a webinar to learn about how electronic payments improve the dental practice revenue cycle. Hear from Dr. Hope Watson, DMD, who will discuss how accepting EFT claim payments has benefited Watson Family Dentistry. This webinar will also address common EFT misconceptions and highlight how providers can reap rewards when working with dental plans and vendors who have adopted EFT standards and their supporting operating rules help to streamline payments.</p> <p>Join us June 8 to improve your practice’s financials!</p> <p><br /><b>Featured Speakers:</b></p> <ul><li>Dr. Hope Watson, DMD</li> <li>Brad Smith, AAP, Senior Director, Industry Engagement and Advocacy, Nacha</li> <li>Bob Bowman, Principal, Interoperability and Standards, CAQH CORE</li> </ul></div> <div class="field field--name-field-registration-link field--type-link field--label-hidden field--item"><a href="https://go.caqh.org/l/339361/2022-05-17/4f9n25">Register Now</a></div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/electronic-payment-impact-dental-practice-financials" data-a2a-title="Electronic Payment Impact on Dental Practice Financials"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Tue, 17 May 2022 16:26:26 +0000 dasteriadis@caqh.org 3841 at https://www.caqh.org CAQH CORE Town Hall https://www.caqh.org/about/event/caqh-core-town-hall-0 <span>CAQH CORE Town Hall </span> <span><span lang="" about="/users/dasteriadiscaqhorg" typeof="schema:Person" property="schema:name" datatype="">dasteriadis@caqh.org</span></span> <span>Tue, 04/26/2022 - 10:20</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2022-05-17T18:00:00Z">May 17, 2022 | 02:00 PM EDT</time> - <time datetime="2022-05-17T19:00:00Z">May 17, 2022 | 03:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>CAQH CORE will provide an update of its work efforts and priority initiatives for 2022 to deliver administrative efficiency and value to the healthcare industry.</p> </div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/caqh-core-town-hall-0" data-a2a-title="CAQH CORE Town Hall "><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-resource-list-title field--type-string field--label-hidden field--item">Presentation Resources </div> <div class="field field--name-field-resource-list field--type-file field--label-hidden field--items"> <div class="field--item"><span class="file file--mime-application-pdf file--application-pdf icon-before"><span class="file-icon"><span class="icon glyphicon glyphicon-file text-primary" aria-hidden="true"></span></span><span class="file-link"><a href="https://www.caqh.org/sites/default/files/core/events/CAQH-CORE-Town-Hall-May-2022-Slides.pdf" type="application/pdf; length=1479301" title="Open file in new window" target="_blank" data-toggle="tooltip" data-placement="bottom">CAQH-CORE-Town-Hall-May-2022-Slides.pdf</a></span><span class="file-size">1.41 MB</span></span></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Tue, 26 Apr 2022 14:20:36 +0000 dasteriadis@caqh.org 3836 at https://www.caqh.org Connectivity https://www.caqh.org/core/connectivity-0 <span>Connectivity</span> <span><span lang="" about="/users/mnewcaqhorg" typeof="schema:Person" property="schema:name" datatype="">mnew@caqh.org</span></span> <span>Wed, 04/13/2022 - 14:40</span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p><span>CAQH CORE Connectivity establishes key connectivity, security and authentication requirements including acknowledgements, error handling, and the CAQH CORE Connectivity “Safe Harbor” creating a national connectivity mechanism that trading partners can be assured will be supported when healthcare information is exchanged. </span></p> <p><span>As the healthcare industry continues to progress toward achieving alignment and interoperability across systems and technologies, updating common methods of connectivity and enhancing security is necessary to ensure requirements continue to meet industry need. </span></p> <p><b><span>Current and Past Versions of CAQH CORE Connectivity</span></b></p> <p><span>All CAQH CORE Infrastructure Operating Rules require the use of the most current CAQH CORE published and adopted version of the CAQH CORE Connectivity Rule.  The most recent published and adopted version of CORE Connectivity: </span><a href="https://www.caqh.org/sites/default/files/core/CAQH%20CORE%20Connectivity%20Rule%20vC4.0.0_0.pdf"><span>CAQH CORE Connectivity Rule vC4.0.0</span></a><span>. </span></p> <p><span>As organizations may be on varying implementation timelines in efforts to migrate to the most current published version of CAQH CORE Connectivity, the table below references all past and current CAQH CORE Connectivity Rules and associated technical documents.  Entities seeking CORE Certification are required at a minimum to implement the version of CORE Connectivity published two years prior from when pursuing certification testing. </span></p> <p><span>Implementers of the HIPAA mandated CAQH CORE Operating Rules are also required to maintain support for CORE Connectivity versions as noted in the table below. </span></p> <p><span>For additional information about implementing CAQH CORE Connectivity, please contact the CAQH CORE Certification team at <a href="mailto:core@caqh.org">core@caqh.org</a>. </span></p> <p><span>For more information about federally mandated operating rules, please click </span><a href="https://www.caqh.org/core/operating-rules-mandate"><span>here</span></a><span>.</span></p> <p> </p> <table class="MsoTableGrid" width="698"><tbody><tr><td> <p align="center"><span><span><span><b><span>CAQH CORE Connectivity Rule</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>SOAP XML Schema</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>SOAP WSDL Schema</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>CAQH CORE-Required Processing Mode Payload Type Tables</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>Original Publication Date</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>Note</span></b></span></span></span></p> </td> </tr><tr><td> <p align="center"><span><span><span><span><a href="https://www.caqh.org/sites/default/files/core/CAQH%20CORE%20Connectivity%20Rule%20vC4.0.0_0.pdf" target="_blank"><b><span>CAQH CORE Connectivity Rule vC4.0.0</span></b></a></span></span></span></span></p> <p align="center"> </p> </td> <td> <p align="center"><span><span><span><a href="https://www.caqh.org/sites/default/files/core/wsdl/CORERule4.0.0.xsd" target="_blank"><b><span><span>XML Schema vC4.0.0 </span></span></b></a></span></span></span></p> </td> <td> <p align="center"><span><span><span><a href="https://www.caqh.org/sites/default/files/core/wsdl/CORERule4.0.0.wsdl" target="_blank"><b><span><span>WSDL Schema vC4.0.0 </span></span></b></a></span></span></span></p> </td> <td> <p align="center"><span><span><span><a href="https://www.caqh.org/sites/default/files/CAQH%20CORE%20Connectivity%20Processing%20Mode%20Payload%20Type%20Table%20%20vC4.0.0.pdf" target="_blank"><b><span><span>CAQH CORE-Required Processing Mode Payload Type Tables</span></span></b><b><span> vC4.0.0</span></b></a></span></span></span></p> </td> <td> <p align="center"><span><span><span>December 2020</span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>N/A</span></b></span></span></span></p> </td> </tr><tr><td> <p align="center"><span><span><span><span><a href="https://www.caqh.org/sites/default/files/core/Connectivity-Rule-vC310.pdf?token=k33dpzhD" target="_blank"><b><span>CAQH CORE Connectivity Rule vC3.1.0</span></b></a></span></span></span></span></p> </td> <td> <p align="center"><span><span><span><a href="https://www.caqh.org/sites/default/files/core/wsdl/CORERule4.0.0.xsd" target="_blank"><b><span><span>XML Schema vC3.1.0</span></span></b><b> </b></a></span></span></span></p> </td> <td> <p align="center"><span><span><span><a href="https://www.caqh.org/sites/default/files/core/wsdl/CORERule4.0.0.wsdl" target="_blank"><b><span><span>WSDL Schema vC3.1.0</span></span></b><b> </b></a></span></span></span></p> </td> <td> <p align="center"><span><span><span><a href="https://www.caqh.org/sites/default/files/core/Connectivity-Rule-Payload-Table-vC310.pdf?token=LmmByI3G" target="_blank"><b><span><span>CAQH CORE-Required Processing Mode Payload Type Tables</span></span></b><b><span> vC3.1.0</span></b></a></span></span></span></p> </td> <td> <p align="center"><span><span><span>September 2015</span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>N/A</span></b></span></span></span></p> </td> </tr><tr><td> <p class="text-align-center"><span><span><span><span><a href="https://www.caqh.org/sites/default/files/core/phase-ii/policy-rules/Connectivity-Rule-vC220.pdf?token=bNhpo5kH" target="_blank"><b><span>CAQH CORE Connectivity vC2.2.0</span></b></a></span><b><span><span>*</span></span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><a href="https://www.caqh.org/sites/default/files/core/wsdl/CORERule2.2.0.xsd?token=4oHOkzHO"><b><span><span>XML Schema vC2.2.0</span></span></b></a></span></span></span></p> </td> <td> <p align="center"><span><span><span><a href="/sites/default/files/core/wsdl/CORERule2.2.0.wsdl"><b><span><span>WSDL Schema vC2.2.0</span></span></b></a></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>N/A</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span>July 2008</span></span></span></p> </td> <td valign="top"> <p align="center"><span><span><span>Required to be supported under Affordable Care Act (ACA)-mandated Operating Rules for eligibility &amp; benefits, claim status, and ERA transactions. </span></span></span></p> </td> </tr><tr><td> <p class="text-align-center"><span><span><span><span><a href="https://www.caqh.org/sites/default/files/Connectivity-Rule-vC110_0.pdf" target="_blank"><b><span>CAQH CORE Connectivity vC1.1.0</span></b></a></span><b><span><span>*</span></span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>N/A</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>N/A</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span><b><span>N/A</span></b></span></span></span></p> </td> <td> <p align="center"><span><span><span>July 2008</span></span></span></p> </td> <td valign="top"> <p align="center"><span><span><span>Required to be supported under Affordable Care Act (ACA)-mandated Operating Rules for eligibility &amp; benefits transactions. </span></span></span></p> </td> </tr></tbody></table><p><span><span><span><i><span>*</span></i><i>In 2020, CAQH CORE implemented a </i><a href="https://www.caqh.org/core/new-operating-rule-structure"><i>New Operating Rule Structure</i></a> <i>to transition</i> <i>the CAQH CORE Operating Rules from phase-based rule sets to rule sets based on business transactions. </i></span></span></span></p> </div> <div class="field field--name-field-taxonomy-type field--type-entity-reference field--label-inline"> <div class="field--label">Type</div> <div class="field--item"><a href="/type/description" hreflang="en">Description</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Wed, 13 Apr 2022 18:40:53 +0000 mnew@caqh.org 3553 at https://www.caqh.org New CAQH CORE Operating Rules Webinar https://www.caqh.org/about/event/new-caqh-core-operating-rules-webinar <span>New CAQH CORE Operating Rules Webinar</span> <span><span lang="" about="/users/dasteriadiscaqhorg" typeof="schema:Person" property="schema:name" datatype="">dasteriadis@caqh.org</span></span> <span>Wed, 03/23/2022 - 11:57</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Webinar</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2022-04-27T16:30:00Z">April 27, 2022 | 12:30 PM EDT</time> - <time datetime="2022-04-27T17:30:00Z">April 27, 2022 | 01:30 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Join the CAQH CORE Team to learn more about new and updated CAQH CORE Operating Rules approved with overwhelming support in 2022 for industry implementation, including:</p> <ul><li><strong>NEW</strong> <b> - CAQH CORE Attachments Operating Rules (Prior Authorization and Claims Use Cases): </b>Establish key infrastructure and data content requirements to provide the necessary information to uniformly send electronic attachments and address one of the largest pain points in the attachments workflow – reassociation or linking the attachment with the original prior authorization request or claim submission.</li> <li><b>UPDATED - CAQH CORE Eligibility &amp; Benefits Data Content Rule:</b> enhance the exchange of critical eligibility and benefit information between health plans and providers.</li> <li><b>UPDATED - CAQH CORE Infrastructure Rules:</b> specify an increase in weekly system availability to align with today’s technology and business needs.</li> </ul><p>Speakers will highlight the new rule requirements and how the rules will benefit your organization and reduce burden across the industry. A Q&amp;A portion at the end of the call will ensure all your questions are addressed.<br /><br /><strong>Speakers:<br /><br /> Donna Campbell </strong>Senior Manager Provider Portal and Connectivity, Health Care Service Corporation<br /><br /><strong>Molly Reese</strong> Senior Policy Analyst, American Medical Association<br /><br /><strong>Mahesh Siddanati </strong>Vice President of Digital Initiative, Centene</p> <p> </p> </div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/new-caqh-core-operating-rules-webinar" data-a2a-title="New CAQH CORE Operating Rules Webinar"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-resource-list-title field--type-string field--label-hidden field--item">Presentation Resources </div> <div class="field field--name-field-resource-list field--type-file field--label-hidden field--items"> <div class="field--item"><span class="file file--mime-application-pdf file--application-pdf icon-before"><span class="file-icon"><span class="icon glyphicon glyphicon-file text-primary" aria-hidden="true"></span></span><span class="file-link"><a href="https://www.caqh.org/sites/default/files/core/events/CAQH-CORE-New-Rules-Webinar-Slides-04.27.22.pdf" type="application/pdf; length=2377975" title="Open file in new window" target="_blank" data-toggle="tooltip" data-placement="bottom">CAQH-CORE-New-Rules-Webinar-Slides-04.27.22.pdf</a></span><span class="file-size">2.27 MB</span></span></div> <div class="field--item"><a href="https://www.youtube.com/watch?v=0Auzokv8C4k&amp;list=PLGulir3D2LZSjqI2vTFMyPb_SnN4Z2sJA&amp;index=1" target="_blank" class="field-resource-list-remote-video last" hreflang="en">CAQH CORE New and Updated Operating Rules</a></div> </div> <div class="field field--name-field-resource-list-remote-video field--type-entity-reference field--label-hidden field--items"> <div class="field--item"><a href="/media/252/edit" hreflang="en">CAQH CORE New and Updated Operating Rules</a></div> </div> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Wed, 23 Mar 2022 15:57:59 +0000 dasteriadis@caqh.org 3546 at https://www.caqh.org HIMSS 2022 Conference and Exhibition https://www.caqh.org/about/event/himss-2022-conference-and-exhibition <span>HIMSS 2022 Conference and Exhibition</span> <span><span lang="" about="/users/dasteriadiscaqhorg" typeof="schema:Person" property="schema:name" datatype="">dasteriadis@caqh.org</span></span> <span>Mon, 02/14/2022 - 16:12</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Conference</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2022-03-14T13:00:00Z">March 14, 2022 | 09:00 AM EDT</time> - <time datetime="2022-03-18T21:00:00Z">March 18, 2022 | 05:00 PM EDT</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>CAQH CORE Directors Erin Weber and Bob Bowman will present at the HIMSS 2022 Conference in Orlando, FL. Their session "Mind the Gap: Attachments Operating Rules to Improve Business Processes" will take place on Thursday afternoon.</p> <p><strong>Presentation Summary</strong></p> <p class="Default"><span><span><span><span>CAQH CORE is dedicated to engaging with industry leaders to standardize business processes across the revenue cycle for the benefit of patients, providers and health plans. An industry-wide transition to replace manual processes with electronic, real-time transactions is ongoing to reduce the cost of doing business in healthcare and <a>meaningfully</a></span><span> impact efficiency, productivity, and data quality. </span></span></span></span></p> <p class="Default"><span><span><span><span>Throughout a two-year CAQH CORE initiative, 150 individuals from over 50 organizations from across the industry<b> </b>gathered to guide the development of common approaches for the exchange of attachments to reduce administrative burden. This industry group identified and prioritized the creation of operating rule requirements to address prior authorization and claims as specific use cases.  The finalized rule requirements target key infrastructure requirements, exchange standards, and one of the most significant problem areas in the attachment's workflow process: reassociation of an attachment to the original prior authorization request or claim submission. </span><span><span>In the absence of a HIPAA-mandated standard being named, these requirements provide the industry with direction </span></span>o<span>n how to provide the information necessary to electronically send attachments uniformly and consistently.</span> <span>Along with the updated CAQH CORE Connectivity Rule, they serve as a bridge between existing and emerging standards.</span></span></span></span></p> <div> <div> <div class="msocomtxt" id="_com_2" language="JavaScript"> <p class="MsoCommentText"> </p> </div> </div> </div> </div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/himss-2022-conference-and-exhibition" data-a2a-title="HIMSS 2022 Conference and Exhibition"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Mon, 14 Feb 2022 21:12:15 +0000 dasteriadis@caqh.org 3329 at https://www.caqh.org Thirty-First National HIPAA Summit https://www.caqh.org/about/event/thirty-first-national-hipaa-summit <span>Thirty-First National HIPAA Summit</span> <span><span lang="" about="/users/dasteriadiscaqhorg" typeof="schema:Person" property="schema:name" datatype="">dasteriadis@caqh.org</span></span> <span>Fri, 02/11/2022 - 10:03</span> <div class="field field--name-field-event-type field--type-list-string field--label-hidden field--item">Conference</div> <div class="field field--name-field-start-date field--type-daterange field--label-hidden field--item"><time datetime="2022-03-01T14:00:00Z">March 01, 2022 | 09:00 AM EST</time> - <time datetime="2022-03-04T22:00:00Z">March 04, 2022 | 05:00 PM EST</time> </div> <div class="field field--name-body field--type-text-with-summary field--label-hidden field--item"><p>Join CAQH CORE Director Erin Weber for a virtual session on the CAQH Index and Operating Rules.</p> </div> <span class="a2a_kit a2a_kit_size_36 addtoany_list" data-a2a-url="https://www.caqh.org/about/event/thirty-first-national-hipaa-summit" data-a2a-title="Thirty-First National HIPAA Summit"><a class="a2a_button_twitter"></a><a class="a2a_button_linkedin"></a><a class="a2a_button_facebook"></a></span> <div class="field field--name-field-taxonomy-caqh-program field--type-entity-reference field--label-inline"> <div class="field--label">CAQH Program</div> <div class="field--item"><a href="/programsolution/core" hreflang="en">CORE</a></div> </div> Fri, 11 Feb 2022 15:03:10 +0000 dasteriadis@caqh.org 3327 at https://www.caqh.org