- About CAQH CORE
- Operating Rules
- New Operating Rule Structure
- Eligibility & Benefits
- Claim Status
- Payment & Remittance
- Prior Authorization & Referrals
- Health Care Claims
- Benefit Enrollment
- Premium Payment
- Mandated Operating Rules
- CORE Certification
- Priority Topics
- Join CAQH CORE
- Resource Library
- CAQH ProView
- CAQH ProView for Groups
- CAQH ProView - Dental
- Provider Directory - DirectAssure
- Credentialing Solutions Suite
- COB Smart
Providers and Practice Managers Get Started with CAQH ProView With a single, uniform online application, providers can enter their information free of charge and access, manage and revise that...
The CAQH CORE Payment & Remittance Operating Rule Set addresses a range of operating rule requirements for the HIPAA-mandated EFT and ERA transactions including streamlining provider enrollment...
The CAQH CORE Claim Status Operating Rules enhance the exchange of claim status information between health plans and provider through consistent infrastructure including requirements that allow...
The CAQH CORE Eligibility & Benefits Operating Rules enhance the exchange of eligibility information between health plans and provider through consistent infrastructure and data content...
Keeping Up with the CORE-required Maximum Enrollment Data Sets If you are tasked with implementing the EFT & ERA Enrollment Data Rules, part of the Affordable Care Act (ACA)-mandated CAQH CORE...
Operating Rules Status | Immediate Action Required | Key Dates | Role of CAQH CORE | Getting Involved with CAQH CORE | Education and Outreach | Implementation Resources | ...
CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of...
A CAQH study, conducted by IBM Global Business Services, assessed results achieved by six CORE-certified health plans that represent 33 million covered lives (Aetna, AultCare, BlueCross BlueShield of...
CAQH CORE Body* CAQH CORE Requirements for Rules Approval Level 1: CAQH CORE Subgroups Not addressed in governing procedures, but must occur to ensure consensus building...
Increasing adoption of Electronic Funds Transfer (EFT) to replace paper checks continues to be challenging for many health and dental plans. Trying to enroll all healthcare providers – especially...