CAQH CORE 155 Operating Rules – Batch Response Time Rule

CAQH CORE 155 Operating Rules set one hour as the maximum response time for the availability of the ASC X12 Implementation Acknowledgement (999) as specified in CAQH CORE 155: Batch Response Time Rule. But what is the maximum response time for HTTP message after a file is dropped off? Section 6 of CAQH CORE 153: Connectivity Rule Version 1.1.0 specifies a maximum HTTP Post Reply Message response time of 60 seconds and that any re-transmission not occur sooner than 90 seconds after the original transmission was sent.

If an X12 270 is received in a batch, does the X12 271 have to be returned in a batch? The CAQH CORE Rule does not address this issue. The batch response time rule only requires that a health plan have the batch of responses available by 7:00 AM the next business day following a submission of inquiries by 9:00 PM ET the previous business day. Therefore, the CAQH CORE 155 Rule does not specify whether or not the batch of X12 271 responses must match exactly the batch of X12 270 inquiries. Do the time frames still apply if it is an especially large batch?

Do the CAQH CORE Rules define the batch size? The CAQH CORE 155 Rule does not define batch size. Section 6 of the CAQH CORE 270: Connectivity Rule Version 2.2.0 defines a large batch file (payload) as “A single submission of a message payload that contains more than one X12 Interchange, each of which may contain one or more Functional Groups, each of which may contain one or more X12 transaction sets.”

Implementation of the Phase I, II, and III CAQH CORE Operating Rules is mandated for all HIPAA-covered entities by the ACA (with the exception of requirements pertaining to acknowledgments). HHS will determine if the Phase IV CAQH CORE Operating Rules will be included in any regulatory mandates.

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