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Description
Section: Solutions
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...
Section: CORE
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...
Section: CORE
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...
Section: CORE
The CAQH CORE Eligibility & Benefits Operating Rules enhance the exchange of eligibility information between health plans and provider through consistent infrastructure and data content...
Section: CORE
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...
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...
