Reminder: The Industry-wide Submission Period for the 2014 Market-based Review for CORE Code Combinations is Open

CAQH CORE Reminder The Industry-wide Submission Period for the 2014 Market-based Review for CAQH CORE Code Combinations is Now Open! Take Advantage of YOUR Chance to Influence  the CORE Code Combinations There is a little more than ONE MONTH left to contribute to the CORE Code Combinations, whether or not you are a CORE Participating Organization! The 2014 Market-based Review (MBR) of the CORE-required Code Combinations for the CORE-defined Business Scenarios was launched on 11/26/14, and we want to hear from YOU. Per the established CAQH CORE Code Combinations Maintenance Process, the CAQH CORE Code Combinations Task Group conducts Market-based Reviews justonce a year. The Market-based Review is the industry's annual opportunity to make adjustments to the CORE Code Combinations to address ongoing and evolving business needs. All CORE Participants plus non-CORE Participants that create, use, or transmit HIPAA-covered transactions may submit potential Market-based adjustments for consideration by the Task Group. To receive the full benefits of the CAQH CORE 360: Uniform Use of CARCs & RARCs (835) Rule, we encourage you to take part in the CORE Code Combination Maintenance Process by submitting a response to the CAQH CORE 2014 Market-based Adjustments Form (NOW OPEN). Submitting recommended Market-based Adjustments ensures that the CORE Code Combinations and CORE-defined Business Scenarios reflect YOUR specific business cases/needs and streamline industry use of CARCs and RARCs. Responses to the CAQH CORE 2014 Market-based Review Adjustments Form must be submitted by 5pm ET on Monday, 01/26/15. Don't wait, get your submission in NOW! ADDITIONAL RESOURCES There are several resources available to assist entities in submitting a response for the 2014 MBR: Detailed instructions to assist in the completion of the online form are available HERE. A sample completed CAQH CORE 2014 Market-based Adjustments Formis also available HERE for consultation as entities plan their submission. On 12/10/14, CAQH CORE held a training session to provide the industry with guidance on completing the MBR submission process. A video recording of this training is available online HERE. The training covers: The CORE Code Combinations Maintenance Process. The 2014 Market-based Review Scope and Submission Process. A live demo of how to complete the online MBR Form. About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

CAQH CORE National Webinars - January 2015 Education Events

CAQH CORE National Webinars January Education Events  A Successful and Productive 2015 Begins with CAQH CORE Start your year right with CAQH CORE! Learn about the great advances made by the industry in healthcare data exchange in 2014 and the exciting initiatives planned for 2015. Find out how a large provider organization has implemented and is benefitting from CAQH CORE 360: Uniform Use of CARCs and RARCs Rule, and how you too can do the same. Jumpstart 2015: Preparing for a Productive Year with CAQH CORE Wednesday, January 14, 2015 | 2:00 - 3:30 pm ET Streamlining Collections and Reducing Costs using CAQH CORE 360 Rule: A Provider's Experience Featuring Emory Health  Thursday, January 22, 2015 | 2:00 - 3:00 pm ET ___________________________________________________________________ Jumpstart 2015:  Preparing for a Productive Year with CAQH CORE  Wednesday, January 14, 2015 | 2:00 - 3:30 pm ET Register for this event HERE for free 2014 was a successful year for electronic healthcare transactions. Significant progress was made in the adoption of CAQH CORE Operating Rules and important steps were taken toward Administrative Simplification by the industry. 2015 promises to be even more eventful! Join us as we take a look back at industry successes and data we have gathered from 2014, and highlight key initiatives taking place in 2015 at CAQH CORE and in the healthcare industry at-large. 2015 will be a big year and we will make sure you are ready for it. _____________________________________________________________ Streamlining Collections and Reducing Costs using CAQH CORE 360 Rule: A Provider's Experience Featuring: Emory Healthcare Thursday, January 22, 2015 | 2:00 - 3:00 pm ET Register for this event HERE for free CAQH CORE 360: Uniform Use of CARCs and RARCs Rule is providing significant benefits for all industry entities, and especially for providers. Emory Healthcare, the largest health care system in Georgia, will share their experiences in implementing the CAQH CORE 360 Rule and the improvements they are seeing in their denial management and collections processes, leading to increased efficiency and cost savings for the organization as a whole. Emory Healthcare will walk us through their preparation and execution for implementing this rule and offer lessons learned to help other organizations achieve the same success they have enjoyed over the last year.

CAQH CORE Announces Launch of 2014 Market-based Review for CORE Code Combinations

2014 Market-based Review of CORE Code Combinations The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today launched the industry-wide submission period for the 2014 Market-based Review (MBR) of the CORE-required Code Combinations for the CORE-defined Business Scenarios.  Per the established CAQH CORE Code Combinations Maintenance Process, the CAQH CORE Code Combinations Task Group (CCTG) conducts two types of reviews and adjustments: Compliance-based Reviews and Market-based Reviews. Market-based Reviews occur once per year and enable the industry to make adjustments to the CORE Code Combinations to address ongoing and evolving business needs. The 2014 MBR will consider adjustments to the existing four CORE-defined Business Scenarios and the potential addition of new CORE-defined Business Scenarios, with associated code combinations. 2014 MBR INDUSTRY-WIDE SUBMISSION PERIOD To satisfy the CAQH CORE 360: Uniform Use of CARCs and RARCs (835) Rulegoal to support maintenance requirements and ensure that the MBR process addresses evolving industry business needs, the CCTG created the components of the online CAQH CORE 2014 Market-based Adjustments Form. The form will be used to collect the necessary input from the industry so thoughtful maintenance can occur.  Due Date: Responses to the 2014 MBR must be received by 5pm ET on Monday, 01/26/15. Who Can Submit: All CORE Participants, plus non-CORE Participants that create, use, or transmit HIPAA-covered transactions, may submit potential Market-based adjustments via the online CAQH CORE 2014 Market-based Adjustments Form.  Getting Started: Eligible entities wishing to participate in the 2014 MBR can begin by completing Part 1 of the online 2014 Market-based Adjustments Form HERE. ADDITIONAL RESOURCES Detailed instructions to assist in the completion of the online CAQH CORE 2014 Market-based Adjustments Form are available HERE. A sample completed CAQH CORE 2014 Market-based Adjustments Form is also available HERE for consultation as entities plan their submission. Additionally, CAQH CORE education sessions will be offered explaining the MBR submission process. If you need additional assistance in navigating the Market-based Adjustments Form or have any questions regarding the 2014 MBR, please email core@caqh.org.

2014 Market-based Review of CORE Code Combinations will Launch November 26, 2014

Advance Notice: 2014 Market-based Review of CORE Code Combinations On November 26, 2014, the CAQH® Committee on Operating Rules for Information Exchange (CORE®) will launch the 2014 Market-based Review (MBR) of theCORE-required Code Combinations for the CORE-defined Business Scenarios. Per the established CAQH CORE Code Combinations Maintenance Process, the CAQH CORE Code Combinations Task Group (CCTG) conducts two types of reviews and adjustments:  Compliance-based Reviews occur three times per year and only consider updates to the published CARC and RARC lists since the last version of theCORE Code Combinations. Market-based Reviews occur once per year and enable the industry to make adjustments to the CORE Code Combinations to address ongoing and evolving business needs. SCOPE OF THE 2014 MBR The 2014 MBR will consider adjustments to the existing four CORE-defined Business Scenarios and the potential addition of new CORE-defined Business Scenarios. Potential industry submissions include:  Code additions, removals, and relocations to code combinations in theexisting CORE-defined Business Scenarios. Requests for potential new CORE-defined Business Scenarios. Code combinations for association with the requested new CORE-defined Business Scenarios. INDUSTRY-WIDE 2014 MBR SUBMISSION PERIOD To satisfy the CAQH CORE 360: Uniform Use of CARCs and RARCs (835) Rulegoal to support maintenance requirements and ensure that the MBR process addresses evolving industry business needs, the CCTG created the components of the online 2014 MBR Submission Form. The form will be used to collect the necessary input from the industry so thoughtful maintenance can occur.  Submission Period:  The 2014 MBR Submission Form will open on Wednesday, 11/26/14. Responses to the Market-based Review must be received by 5pm ET onMonday, 01/26/15. Who Can Submit:  The Submission Period is open to all applicable industry entities. All CORE Participants, plus non-CORE Participants that create, use, or transmit HIPAA-covered transactions, may submit potential Market-based adjustments via the online 2014 MBR Submission Form. A link to the online submission form will be provided in the formal launch announcement, along with detailed instructions to assist respondents in completing the form. Additionally, CAQH CORE will announce education sessions that will explain the MBR submission process. Please do not hesitate to contact core@caqh.org with any additional questions.

CAQH CORE National Webinar - Nov. 19, 2014 - Open Mic Session with CAQH CORE

CAQH CORE National Webinar  CAQH CORE Open Mic Session -  Now is the Chance to Get All of Your Questions Answered November 19, 2014 2:00 PM - 3:00 PM ET REGISTER There is no fee to attend  YOU asked, WE listened Welcome to the CAQH CORE Open Mic webinar Is your organization receiving all the advantages of CAQH CORE Operating Rules? Are you ready for the HHS final Rule on Health Plan Certification? Do you have questions about the Third Set of ACA-mandated Operating Rules? Please join us for this special 'Open Mic' session to get your questions answered by CAQH CORE experts. Based on your feedback, this session is designed as an open forum - one full hour - to enable you to ask your questions about the following topics: Voluntary CORE Certification CAQH CORE actions in response to the HHS NPRM on Health Plan Certification Rule development for the Third Set of ACA-mandated CAQH CORE Operating Rules CAQH CORE EFT & ERA Operating Rules and maintenance You will be able to ask questions via web and phone during this event. We encourage you to submit your questions when you register. Who Should Attend All HIPAA-covered entities that are currently in compliance with the EFT & ERA operating rules and those that want to ensure they are fully benefiting from the CARCs and RARCs Rule Note: A working knowledge of Federally Mandated CAQH CORE EFT & ERA Operating Rules is assumed. Register Now to Reserve Your Spot for This Free Education Session About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

CAQH CORE National Webinar - Nov. 13, 2014 - Transforming Financial Transactions through CAQH CORE Operating Rules

CAQH CORE NATIONAL WEBINAR FEATURING HCA AND CNSI Transforming Financial Transactions through CAQH CORE Operating Rules: A Medicaid Perspective November 13, 2014 2:00 PM - 3:00 PM ET REGISTER There is no fee to attend. A Medicaid Success Story about Financial Gains  through CAQH CORE Operating Rules Join us for this special webinar with the Washington Healthcare Authority (HCA)and its partner, CNSI, to find out how the CAQH CORE Operating Rules are transforming healthcare financial transactions, with a focus on the significance of Medicaid involvement. HCA and CNSI will share their CAQH CORE Operating Rules implementation strategy, lessons learned and best practices in configuring their MMIS to ensure operational compliance. In this session  Learn about HCA's implementation strategy for Phase I, II and III CAQH CORE Operating Rules Receive information about timelines and successful resolution of challenges during implementation Benefit from HCA's implementation learnings and how they achieved maximum value from Operating Rules implementation Get valuable insight into the significant gains achieved through Operating Rule implementation through early operational metrics shared by HCA and CNSI Participate in Q&A with representatives of HCA, CNSI and CAQH CORE Who Should Attend This session will be especially beneficial to State Medicaid Agencies to understand how they can benefit from the CAQH CORE Operating Rules, but the key lessons, benefits and best practices discussed during this webinar extend to other health plans, providers, clearinghouses and vendors that should currently be in compliance with the CAQH CORE Operating Rules. Note: A working knowledge of Federally Mandated CAQH CORE Operating Rulesis assumed. Register Now to Reserve Your Spot for This Free Education Session About HCA The Washington State Health Care Authority oversees the state's two top health care purchasers - Washington Medicaid called Washington Apple Health and the Public Employees Benefits Board (PEBB) Program that provides insurance coverage for eligible employees of state agencies, higher education institutions, certain employer groups and their families. About CNSI CNSI (www.cns-inc.com) is an industry leader in developing, implementing and operating cutting-edge technological solutions that modernize healthcare administration systems. At CNSI we revolutionize the way we manage healthcare through technological innovations which include mobile applications that provide easy access to health benefits, cloud based systems that provide for more efficient processing of medical claims and cutting edge technology that can eradicate improper billing and waste leading to better care, better health and lower costs. About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

CAQH CORE National Webinar - Nov. 6, 2014 - Voluntary CORE Certification

CAQH CORE National Webinar with Edifecs, Featuring Orbograph Over 150 CORE Certifications Achieved to Date!  What are you waiting for?  November 6, 2014 2:00 PM - 3:30 PM ET REGISTER There is no fee to attend  Join the elite group of Industry Leaders that are already CORE-Certified  The second webinar in our popular series of CAQH CORE National Webinars onVoluntary CORE Certification is right around the corner! Don't miss this opportunity to hear from Phase III CORE Certified entity, Orbograph, about how they are leveraging their CORE Certification and the benefits they are already seeing. Let CORE-authorized testing vendor, Edifecs, share the best practices they have learned from their experience working with industry leaders on over 150 CORE Certifications. On top of all this, you will also get an update from CAQH CORE about actions related to the Department of Health and Human Services (HHS) Notice of Proposed Rulemaking (NPRM) on ACA-mandated Health Plan Certification.  In this session: We have gathered industry experts to help you realize the advantages of Voluntary CORE Certification.  Orbograph: Get insights into the real and practical value of Voluntary CORE Certification and how you can use the CORE Seal to your advantage. Hear about the process, planning and other considerations to successfully achieve CORE Certification. Edifecs: Receive tips and advice gathered from working with various entities like you about successfully pursuing CORE Certification. Become familiar with Edifecs' CORE-authorized testing platform. CAQH CORE:  Find out how Voluntary CORE Certification is an integral piece for maximizing the value of Operating Rules within your organization. Learn about actions CAQH CORE has taken as a result of the HHS NPRM on Health Plan Certification and how CORE Certification is related to the proposed rule. Participate in Q&A with Orbograph, Edifecs and CAQH CORE. Who Should Attend: This session will be especially beneficial to providers, health plans and vendors to understand how they can attain Voluntary CORE Certification and fully benefit from the EFT & ERA Operating Rules. Note: A working knowledge of Federally Mandated CAQH CORE EFT & ERA Operating Rules is assumed. Register Now to Reserve Your Spot for This Free Education Session About Orbograph Orbograph, a subsidiary of Orbotech, is a premier supplier of electronic/paper automation solutions in healthcare revenue cycle management (RCM) and recognition software for the U.S. check and lockbox processing markets. Orbograph technologies are in use in over 1,600 financial institutions, service bureaus, clearinghouses and billers processing billions of checks and claims annually. The cloud-based Healthcare Payments Automation Center (HPAC) is "Enabling Transformation of Healthcare Payments" by converting paper-based EOBs, correspondence and patient payments and reconciling EFT/ACH payments to ERAs via reassociation. Orbograph recognition technologies are installed in 20 of the top 30 U.S. financial institutions with in-house check processing. About Edifecs Edifecs is the first testing vendor authorized by CORE. To date, more than 35 health plans, large provider groups and health information technology vendors have used Edifecs' Web-based CORE Certification Testing Platform to demonstrate their conformance with CAQH CORE Operating Rules. In addition to solutions that enable mandate compliance, Edifecs also offers healthcare IT solutions that foster collaboration between payers, providers and consumers to improve clinical outcomes, operations and financial performance. About CAQH CORE CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Department of Health and Human Services (HHS) as an author for ACA-mandated operating rules.