CAQH CORE HTTP/S

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 →

CAQH CORE Batch Processing

CAQH CORE Batch Processing Vendor Requirements CAQH CORE Batch Processing: Why not FTP or sFTP for batch transactions instead of HTTP/S?HTTP/S is robust and has a proven track record with batch transactions. The benefits of a single communication standard were a compelling reason to mandate its availability. Information sources that allow FTP and/or sFTP for Read More →

EDI HTTP

EDI HTTP Guidelines For CAQH CORE 250: Claim Status Infrastructure Rule EDI HTTP guidelines refer to parties contracting with Medicare and CAQH CORE-authorized testing vendors. One of the typical questions from vendors – “Is there a required format in Phase I CAQH CORE Connectivity for the authorization, date/time, and payload ID to be sent in the Read More →

MDM-Health-Care

X12 270 271 Transactions Tracking (CAQH CORE 155 Rule) X12 270 271 Transactions can be tracked throughout a system/application to demonstrate conformance with the response time requirements specified in the CAQH CORE 155 Rule. The CAQH CORE Response Time Rules (CAQH CORE 155 & 156 Rules) require HIPAA covered entities to capture, log, audit, match, and report the date, time, Read More →

CAQH CORE Eligibility Data

CAQH CORE Eligibility Data Content Rules – Frequently Asked Questions CAQH CORE Eligibility Data Content Rules (CAQH CORE 154 & 260 Rules) do not require that the X12 271 response to an X12 270 inquiry include a specified grouping of Service Type Codes (STCs), so are health plans/information sources prohibited from returning such an STC Read More →

EDI Testing CAQH CORE

EDI Testing CAQH CORE 153 Trading Partner Guidelines EDI Testing CAQH CORE 153 Basics must be combined when determining the overall CAQH CORE Connectivity requirements. Find the fourth part of EDI Testing CAQH CORE FAQs for trading partners below. 1.For batch response pick-up, does CAQH CORE intend for this to be a programmatic interface or a human interface? Under Read More →

CAQH CORE 153 Batch Processing

CAQH CORE 153 Batch Processing (Integration and Testing Guidelines) CAQH CORE 153 Batch Processing rules provide special testing batch processing guidelines for CAQH CORE-authorized and new vendors. Part 2 FAQs are provided below. 1.Batch processing: Will a receiver be able to re-pickup a file if needed? CAQH CORE does not specify this, but recommends that information sources allow for re-pickup Read More →

CAQH CORE 153 Batch

CAQH CORE 153 Batch Processing FAQs CAQH CORE 153 Batch Processing basic rules provide integrity guidelines for CAQH CORE-authorized and new testing vendors. Part 1 FAQs are provided below. 1.Batch processing: Why not FTP or sFTP for batch transactions instead of HTTP/S? HHTTP/S is robust and has a proven track record with batch transactions. The benefits of a single Read More →

CAQH CORE 153 EDI

CAQH CORE 153 EDI Connectivity Rule (Eligibility & Claim Status Operating Rules) CAQH CORE 153 EDI Connectivity Rule must be combined when determining the overall CAQH CORE Connectivity requirements. The Part 1 of CAQH CORE 153 EDI Connectivity Rule FAQs is given below. 1. How did CAQH CORE decide that HTTP/S is secure and reliable enough to protect the delivery of Read More →