Eligibility And Claim Status CAQH CORE Companion Guides For Trading Partners and Providers Eligibility And Claim Status companion guides can be independently created by health plans so they can often vary in format and structure. Such variance can be confusing to trading partners and providers. CAQH CORE adapted its CAQH CORE Master Companion Guide Template based on the CAQH/WEDI Read More →

CAQH CORE HIPAA Operating Rules (Eligibility & Claim Status) CAQH CORE HIPAA Operating Rules are mandated for all HIPAA-covered entities by the ACA (with the exception of requirements pertaining to acknowledgments). Find CAQH CORE HIPAA Operating Rules (Eligibility & Claim Status) in the form of FAQs below. What do the Phase I and Phase II CAQH CORE Eligibility & Read More →

270/271 HIPAA Transaction Validation (Pre-Query and Post-Query) (Washington State Health Care Authority) 270/271 HIPAA Transaction validation (Washington State Medicaid’s 270/271 transaction) will perform a pre-query validation to make sure the required Subscribe data elements are preset prior to routing the information to Eligibility and Benefit system. For Subscriber request below data elements can be submitted: Read More →

Acknowledgement Procedures 270/271 Transaction Notes (Washington State Health Care Authority) Acknowledgement Procedures 270/271 transaction subject general HIPAA standard requirements as well as Health Care Authority 270/271 transaction guidelines. HIPAA EDI allows covered entities to submit and retrieve the HIPAA mandated transactions from Washington State Medicaid. Covered entities (clearinghouses, providers, health plans) are required to successfully complete EDI testing for Read More →