CAQH CORE 250: Claim Status Infrastructure Rule Guides
CAQH CORE 250 Rule for operating rules for the eligibility and claim status transactions adopts all the Phase I and II CAQH CORE Eligibility and Claim Status Operating Rules except those requirements pertaining to the use of Acknowledgements. Entities seeking CORE Certification must implement all of the CAQH CORE Eligibility and Claim Status Operating Rules applicable to their stakeholder type, including those rules & rule requirements pertaining to use of Acknowledgments.
An entity that processes X12 270/271 eligibility transactions, and does not process claim status transactions can become Phase II CORE-certified, that is the Phase II CAQH CORE Operating Rules do not require an organization to conduct, use or process the X12 276/277 claim status transactions if it does not currently do so.
As a Phase II CORE-certified entity, you are not required to apply the Phase II CAQH CORE Patient Identifiers Rules to the conduct of the claim status transactions as it is specific to the conduct of eligibility/benefits transactions. An entity implementing the X12 276/277 transactions is required to support CAQH CORE Connectivity 270 v 2.2.0 as specified in the CAQH CORE 250 Rule, Section 4.1.