X12 Interchange Acknowledgement (250: Claim Status Infrastructure Rule) X12 Interchange Acknowledgement must be returned for real time X12 276 claim status inquiries if the functional group is rejected, or the X12 277 response, to be conformant with this rule. CAQH CORE Rules do not address usage of the X12 Interchange Acknowledgement TA1.  To send real time acknowledgments Read More →

HIPAA CAQH CORE Batch Processing (250: Claim Status Infrastructure Rule) HIPAA CAQH CORE recognizes that every organization has its own record-retention policies and, therefore, does not mandate a strict requirement for retention of response files. However, CAQH CORE recommends that a copy of responses be kept available for a minimum of six months after they Read More →

HIPAA CAQH CORE

CAQH CORE HTTP/S (250: Claim Status Infrastructure Rule) Connectivity CAQH CORE HTTP/S is secure and reliable enough to protect the delivery of healthcare information over the Internet. In Phase I development discussions, CAQH CORE solicited input on this topic from its Technical Work Group members and experts within healthcare and other industries, such as financial services. Based on Read More →

EDI 837 Institutional Quiz

CGS EDI Enrollment Provider Guidelines CGS EDI Enrollment form (commonly referred to as the EDI Agreement) should be submitted when enrolling for electronic billing. It should be reviewed and signed only by the providers to ensure each provider is knowledgeable of the enrollment request and the associated requirements. Providers that have contracted with a third Read More →