CAQH CORE Connectivity Safe Harbor Guidelines CAQH CORE Connectivity Safe Harbor requirements that a health plan must use if requested by a provider are described in CAQH CORE 270 Rule, Section 5, CORE Safe Harbor. The CAQH CORE Connectivity Safe Harbor specifies connectivity methods that application vendors, providers, and health plans can be assured will be supported … Read More →
CAQH CORE 270: Connectivity Rule: Relationship Between Phase I and Phase II CAQH CORE 270: Connectivity Rule is not a reference to X12 270 eligibility transaction. The CAQH CORE 270: Connectivity Rule Version 2.2.0, is payload agnostic, and is designed to carry any X12 v4010 and v5010 administrative transaction payload as well as any other non-X12 payload. The CAQH CORE … Read More →
CAQH CORE Eligibility & Claim Status Operating Rules: CAQH CORE 260: Eligibility & Benefits Data Content (270/271) Rule As the CAQH CORE Eligibility & Claim Status Operating Rules (CAQH CORE 154 and 260 Rules) do not require that the X12 271 Response to an X12 270 inquiry include a specified grouping of service type codes (STCs), … Read More →
CAQH CORE 260: Eligibility & Benefits (270/271) Data Content Rule Version 2.1.0 CAQH CORE 260: Eligibility & Benefits (270/271) Data Content Rule Version 2.1.0 requires that entities, at a minimum, return the coverage status for each specific benefit (service type) included in a X12 270 eligibility request that is required in response to an explicit inquiry. … Read More →