CAQH CORE 259: AAA Error Code Reporting Rule CAQH CORE 259: Operating Rule states that the receiver of the X12 271 response, i.e., the system that originated the X12 270 inquiry, is required to detect all combinations of error conditions from the AAA segments in the X12 271 responses, and to display to the receiving … Read More →
CAQH CORE 258: Normalizing Patient Last Name Rule CAQH CORE 258 Operating Rule requires the removal of both the apostrophe and the hyphen in the O’Donnell-Griswold example cited. The normalized name would be ODONNELLGRISWOLD. CAQH CORE 258: Last Name Normalization Rule Version 2.1.0 does not address this specific scenario. Since the characters “De” are not included in … Read More →
X12 276/277 Transactions In CAQH CORE 250: Claim Status Rule X12 276/277 Transactions can be tracked throughout a system/application to demonstrate conformance with the response time requirements specified in the CAQH CORE 250 Rule. CAQH CORE 250: Claim Status Rule requires HIPAA covered entities to capture, log, audit, match, and report the date, time, and control … Read More →
CAQH CORE HTTP/S Vendor Parties Guidelines CAQH CORE HTTP/S vendor rules do not require that an entity (provider or health plan) implement the technology directly into their own data center. The Phase I CAQH CORE Rules implicitly acknowledge that both providers and health plans will use technology solutions provided by vendors to accomplish all that must … Read More →