CAQH CORE and Edifecs Education Session - June 10, 2014 - Advantages of EFT & ERA Operating Rule Implementation and Voluntary CORE Certification

CAQH CORE and Edifecs Joint Education Session Featuring athenahealth Advantages of EFT & ERA Operating Rule Implementation and Voluntary CORE Certification:   athenahealth - A Provider-facing Vendor Perspective June 10, 2014 2:00 PM - 3:30 PM ET REGISTER There is no fee to attend  Learn from a leading Practice Management System and EMR vendor how to maximize the benefits of EFT & ERA implementation and Voluntary CORE Certification! The role of the provider-facing vendor in Operating Rule implementation and CORE Certification is unique given the vendor is essential in ensuring that all HIPAA-covered entities, especially providers, are both compliant with, and realizing the full benefits of the CAQH CORE Operating Rules. Join CORE Participant and Phase III certified vendor organization, athenahealth, as they share insights about how they successfully implemented the EFT & ERA Operating Rules and achieved Voluntary CORE Certification.  Also receive information from CORE-authorized testing vendor, Edifecs, about their CAQH CORE Operating Rule testing platform. Featured panelists: Neil Dean from athenahealth Vijay Bhuttar from Edifecs Bob Bowman from CAQH CORE In this session: Hear from athenahealth about: Planning for implementation Innovative approaches to challenges The role of the vendor in CORE Certification Testing Coordinating with business associates Successful pursuit and benefits of CORE Certification Learn more about Voluntary CORE Certification and how it can play a vital role in your CAQH CORE Operating Rules and ACA Mandate compliance validation Receive information from Edifecs about the CAQH CORE Operating Rule testing platform and how they work with entities seeking CORE Certification Who Should Attend: This session will be especially beneficial to providers to understand how they can benefit from the EFT & ERA Operating Rules. Health plans, clearinghouses and vendors that should currently be in compliance with the EFT & ERA Operating Rules and those that want to ensure they are fully benefiting from the Operating Rules will also be able to take advantage of this session.    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 athenahealth athenahealth is a leading provider of cloud-based services for electronic health record (EHR), practice management, and care coordination. athenahealth's mission is to be caregivers' most trusted service, helping them do well doing the right thing. For more information, please visit www.athenahealth.com. About Edifecs Edifecs is the first testing vendor authorized by CAQH 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 the 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. To learn more about CAQH CORE, visit www.caqh.org.

Updated Version of CORE Code Combinations Available for Implementation

Updated Version Available for Implementation: June 2014 CORE Code Combinations v3.1.0 - Includes Adjustments for 2013 Market-Based Review and the Latest Compliance-based Review To: All HIPAA Covered Entities and Business Associates    From: The CAQH CORE Code Combinations Task Group Co-Chairs    An updated version of the CORE-required Code Combinations for the CORE-defined Business Scenarios (CORE Code Combinations) is now available for use with CAQH CORE 360: Uniform Use of CARCs and RARCs Rule. CAQH CORE Rule 360 enables more uniform use of the Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) by targeting a minimum set of common or problematic Business Scenarios, along with a maximum specified set of code combinations for each of these Scenarios. Per CAQH CORE policy, the CORE Code Combinations must be updated by Task Group approval to both: Align with the current published CARC and RARC lists which are maintained by code committees and updated at least three times per year. (Compliance-based reviews) Address an annual review. (Market-based reviews)      The CORE-required Code Combinations for the CORE-defined Business Scenarios v3.1.0 June 2014 is now available on the CAQH CORE website for use with CAQH CORE 360 Rule. The June 2014 CORE Code Combinations includes: Compliance-based Adjustments as a result of code list updates published on March 1st and March 15th Market-based Adjustments based upon the 2013 Market-based Review Emergency Code Combination Additions1 Non-substantive updates have been made for ease of use A marked-up version of the June 2014 CORE Code Combinations showing both Compliance-based and Market-based Adjustments between v.3.0.4 and v.3.1.0 is available HERE. The Change Log in the second tab of the CORE Code Combinations provides a list of all adjustments made to the CORE Code Combinations. The format of the CORE Code Combinations was updated per request of CORE and non-CORE participants ease of use to include: A row for each CARC that does not require a RARC so implementers may easily view available code combinations that only include a CARC and CAGCs A Master Tab added to the current version that includes all CORE Code Combinations in a single tab For more information visit the Ongoing Maintenance of the CORE Code Combinations for CAQH CORE 360 Rule Webpage, a "one stop shop" for all the necessary tools and information to comply with CAQH CORE 360 Rule and the ongoing maintenance process. This website page include summary of the updates and links to detailed updates. The CAQH CORE Code Combinations Task Group will launch its next Compliance-based Review in July in order to review updates from the code list authors that are scheduled for publication in July, 2014. CAQH CORE Participants are encouraged to get involved with the Task Group. Beyond the Compliance-based review, the Task Group will also begin planning for process improvements for the annual Market-based Review. Please do not hesitate to contact core@caqh.org with any additional questions.   [1] Emergency Code Combination Additions (ECCA) are code combinations that originated through the formal ECCA Request Process  These requests could be in response to newly enacted federal or state legislative or regulatory action or to support new product lines offered to the market by public (e.g., Medicare, Medicaid) or commercial health plan issuers. Per policy, they are very limited and require co-chair approval.

One Day Left!: Request for Industry Input on Draft HIPAA Credential Forms - Deadline is Tuesday, 06/03/14

One Day Left!  Your Input Needed on  Draft HIPAA Credential Forms-  Feedback Deadline is Tomorrow, Tuesday, June 3rd   Background On May 6, 2014, CAQH CORE announced a month-long public feedback period for both CORE and non-CORE Participants on the Draft HIPAA Credential Forms. These forms were developed in response to the January 2, 2014 Department of Health and Human Services (HHS) Notice of Proposed Rule Making (NPRM), "Administrative Simplification: Certification of Compliance for Health Plans."  There is one day remaining to submit your organization's feedback - feedback must be submitted by 5 pm ET tomorrow, Tuesday, June 3, 2014. Input should be limited to the clarity of the submission instructions, content of the draft forms, layout, and automation of the forms within the context and boundaries of the NPRM. Out of scope input, such as feedback on the NPRM provisions, including the proposed structure of the HIPAA Credential Program, will not be considered. Purpose The goal is to help the industry prepare for the proposed HIPAA Credential Program, which will help inform HHS development of the Final Rule. Please Note: This industry feedback process assumes that further revision to the forms will be required after the Final Rule is published.  Instructions for Requested Input Written input must be submitted via the feedback template provided by CAQH CORE. Input will be reviewed by the CAQH CORE Certification/Testing Subgroup, and a revised set of forms will be published after that review is complete. Final forms will not be produced until after the Final Rule is published. For more detail on the process to collect industry input and revise the Draft HIPAA Credential Forms, as well as potential scenarios for your organization to consider as it provides feedback, see the discussion slides (HERE).  See also additional background on the NPRM and links to the Feedback Template and Draft HIPAA Credential Forms below. Feedback Template  Feedback Template Draft HIPAA Credential Forms  Draft HIPAA Credential - Attestation of HIPAA Compliance Form Draft HIPAA Credential - Application Form Draft HIPAA Credential - Attestation of Trading Partner Testing Form Due Date Please coordinate within your organization to submit only one response. Written feedback to the draft forms must be returned via the feedback template to CAQH CORE at core@caqh.org by 5 pm ET tomorrow, Tuesday, June 3, 2014.