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 →
CAQH CORE 154 X12 271 Response Back Guides CAQH CORE 154 X12 271 response with the health plan name (assuming it is available within the system[s]) in EB05 element of all EB segments sent back in the response has some notes. Since the CAQH CORE 154 Rule does not explicitly identify which EB segments are to carry … Read More →
CAQH CORE 154 Eligibility & Benefits 270/271 Data Content Rule CAQH CORE 154 Eligibility & Benefits 270/271 eligibility data content rule subjects to the general CAQH CORE 260 Rule X12 270/271 requirements. CAQH CORE 154 Eligibility & Benefits 270/271 Guidelines Code 52 is specific to hospital emergency services; Code 86 is general. CAQH CORE selected Code 86 so that … Read More →
CAQH CORE 154 Eligibility & Benefits 270/271 Data Content Rule CAQH CORE 154 Eligibility & Benefits 270/271 eligibility data content subjects to the Phase I and general CAQH CORE 260 Rule rule requirements for the X12 270/271. CAQH CORE 154 Eligibility & Benefits 270/271 Notes The CAQH CORE 154 Eligibility & Benefits (270/271) Data Content Rule Version 1.1.0 does not … Read More →