CAQH CORE 250 Claim Status Infrastructure Rule Certification CAQH CORE 250 Rule states that an entity that processes X12 270/271 eligibility transactions, and does not process claim status transactions can become Phase II CORE-certified. Phase II CAQH CORE Operating Rules do not require an organization to conduct, use or process the X12 276/277 claim status transactions … Read More →
CORE 157: Eligibility and Benefits System Availability Rule Basic Guidelines CORE 157: Eligibility and Benefits System Availability Rule states that system availability must be no less than 86 percent per calendar week for both real time and batch processing modes. This will allow for health plan, (or other information source) clearinghouse/switch or other intermediary system … Read More →
CAQH CORE 250: Claim Status Infrastructure Rule CAQH CORE 250: Claim Status Infrastructure Rule applies when an entity uses, conducts, or processes the HIPAA-adopted X12 276/277 Health Care Claim Status Request and Response transactions. The CAQH CORE 250: Claim Status Rule relates to the Phase I CAQH CORE Rules in the following ways: The Phase I CAQH CORE … Read More →
CAQH CORE 156 Rule Transactions Tracking: How should the X12 270/271 transactions be tracked? CAQH CORE 156 Rule Transactions tracking can be done throughout a system/application to demonstrate conformance with the response time requirements specified in the CAQH CORE 156 Rule. The CAQH CORE Response Time Rules (CAQH CORE 155 & 156 Rules) require HIPAA covered entities to capture, log, … Read More →