Data Content Rules (CAQH CORE 154 & 260 Rules) – Health Plans Requirements Data Content Rules (CAQH CORE 154 & 260 Rules) require health plans to address the situation where a patient’s benefit coverage changes from the time of the X12 270 Inquiry to the date of service. True or false? Actually the CAQH CORE … Read More →
CAQH CORE 155 Operating Rules – Batch Response Time Rule CAQH CORE 155 Operating Rules set one hour as the maximum response time for the availability of the ASC X12 Implementation Acknowledgement (999) as specified in CAQH CORE 155: Batch Response Time Rule. But what is the maximum response time for HTTP message after a … Read More →
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 →
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 →