Description

Section: CORE
The Complete Set of Phase III CAQH CORE EFT & ERA Operating Rules, developed by CORE Participants with industry input, was approved in the final CORE vote in June 2012 as the final step in the...
Section: CORE
In December 2011, CMS issued a notice adopting CMS-0032-IFC: Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions as...
Section: CORE
In December 2011, CMS issued a notice adopting CMS-0032-IFC: Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions as...
Section: CORE
Keeping Up with the CORE-required Maximum Enrollment Data Sets If you are tasked with implementing the CAQH CORE 380: EFT Enrollment Data Rule and the CAQH CORE 382: ERA Enrollment Data Rule, part...
Section: CORE
Operating Rules Status  |   Immediate Action Required  |   Key Dates  |   Role of CAQH CORE  |  Getting Involved with CAQH CORE  |   Education and Outreach  |   Implementation Resources  |  ...
Section: About
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...
Section: CORE
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...
Section: CORE
*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...
Section: Solutions
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...
Section: Solutions
Difficulties associated with the coordination of benefits process - from manual processes to prolonged and error-prone payment cycles - make the healthcare system cumbersome for patients with...

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