The new Phase IV CAQH CORE Operating Rules address infrastructure requirements and build on the industry’s familiarity with previous operating rule requirements to ensure there is a foundational set of national infrastructure rules for all HIPAA-mandated transactions. This webinar will give a detailed overview of the infrastructure requirements within the new Phase IV CAQH CORE Operating Rules as well as describe how implementation will lead to added business value, such as increased efficiency, revenue and customer satisfaction. 

PokitDok's technology powers transactions for the business of health, connecting doctors with patients, providing business functions for healthcare providers and payers, and making electronic medical records communicate. They have demonstrated their commitment to interoperalibily by implementing the CAQH CORE Operating Rules for the transactions they use – eligibility, claims status and electronic remittance advice – and have also recently achieved voluntary CORE Certification.

Connectivity and electronic exchange of data go hand in hand. The new Phase IV CAQH CORE 470 Connectivity Rule, which applies to all of the Phase IV transactions, enhances interoperability, efficiency and security, and brings forward existing CORE technical requirements, such as real time vs. batch processing modes and the Guiding Principle of Safe Harbor Connectivity among trading partners. And learn about how the Phase IV Connectivity works in unison with the earlier phases and how it applies to your stakeholder type. 

CAQH CORE, the American Medical Association and the Veterans Health Administration have joined forces to talk about the benefits of going paperless in healthcare financial transactions and resources available to help you with your implementation efforts. We will also have several case studies on the time-saving benefits of switching from paper checks and explanation of benefits to the healthcare electronic funds transfer (EFT) and electronic remittance advice (ERA).

CAQH CORE Town Hall webinars provide the public with an update on CORE's recent activities related to industry development and/or implementation of healthcare operating rules. Learn about federally mandated and voluntary CAQH CORE Operating Rules, voluntary CORE Certification, CORE Code Combinations and how they can improve your organization’s denial management process, CAQH CORE’s plans for value-based payments, and much more. 

Please join us for this special "Open Mic" session to get your questions answered by the CAQH CORE team of experts. Based on your feedback, this session is designed as an open forum – one full hour - to enable you to ask your questions. We encourage you to submit your questions when you register. You will also be able to ask questions via web during this event. 

This call is open to all non-CORE and CORE Participants and is for informational purposes only; no voting or decisions will occur. If you have any questions, please contact CORE@caqh.org. 

The Complete Set of Phase IV CAQH CORE Operating Rules, which address HIPAA transactions including Claims, Prior Authorization, Enrollment, & Premium Payment were approved through the CAQH CORE voting process in September 2015. This webinar will give a detailed overview of the four Phase IV Infrastructure Rules as well as provide an update of new resources and tools to support industry implementation of the new Phase IV operating rules. 

What is the value of pursuing Voluntary CORE Certification? Is there a strategic reason to be conformant with the operating rules beyond compliance? We will talk about this as well as lead you step by step through the CORE Certification process. 

This call is open to all non-CORE and CORE Participants and is for informational purposes only; no voting or decisions will occur. If you have any questions, please contact CORE@caqh.org.

The CAQH CORE 360: Uniform Use of CARCs and RARCs Rule provides uniformity in the use of claim payment adjustment/denial codes in defined universal business scenarios. The Market-based Review is the industry’s annual opportunity to make adjustments to the CORE Code Combinations to address ongoing and evolving business needs. The 2015 CAQH CORE Market-based Adjustment Form (2015 MBR Form) submission period will begin in early December.