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 →
CAQH CORE 156: Real Time Response Time Rule Basic Guidelines CAQH CORE 156: Real Time Response Time Rule indicates that the number of responses returned within the specified timeframe gives a better indication of the information source’s capabilities. Averages can be skewed by outlier responses. Providers do not have to be certified by CAQH CORE to … Read More →
CAQH CORE 154 Rule (Subsection 2.6) – Explicit request for each of the CORE Service Types CAQH CORE 154 Rule requires all CORE-certified entities to be able to support an explicit inquiry about each of the 12 CAQH CORE-required service types. Support means that an entity must be able to receive and respond to an … Read More →