HIPAA CAQH CORE Batch Processing (250: Claim Status Infrastructure Rule)

HIPAA CAQH COREHIPAA CAQH CORE recognizes that every organization has its own record-retention policies and, therefore, does not mandate a strict requirement for retention of response files. However, CAQH CORE recommends that a copy of responses be kept available for a minimum of six months after they are ready in order to support the process of discovery in the case of a complaint of non-conformance against a CORE-certified entity.

Why not FTP or sFTP for batch transactions instead of HTTP/S? HTTP/S is robust and has a proven track record with batch transactions. The benefits of a single communication standard were a compelling reason to mandate its availability. Information sources that allow FTP and/or sFTP for batch transactions still can support those transmission methods. For consistency and ease of development, CAQH CORE decided that it was important to have a single standard. Based on that decision, and the fact that many batch processing information sources cannot commit to having the ASC X12 Implementation Acknowledgement (999) available in 20 seconds, CAQH CORE elected to mandate that the ASC X12 Implementation Acknowledgement (999) not be provided in the HTTP response.
Will a receiver be able to re- pickup a file if needed? CAQH CORE does not specify this, but recommends that information sources allow for re-pickup for at least one month after the initial pickup of a batch response file. CAQH CORE does not set a maximum on the number of response files that a receiver will be able to pickup. Information sources should create policies to specify the limit to the number or size of files that can be picked up and document those policies in their Companion Guide. CAQH CORE does not specify the different types of responses a payload can contain. Please refer to your own internal policies.

Leave a Reply

Your email address will not be published.

Post Navigation