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.

CAQH CORE National Webinars - November Education Events - Register Now

CAQH CORE National Webinars November Education Events: With the Weather Cooling Down, Our Webinars are Heating Up! Our November National Webinars are coming. Find out about Voluntary CORE Certification and how you can join the more than 150 CORE-certified industry leaders who are already benefiting from Operating Rule use. Receive the latest information on CAQH CORE activities in response to the Department of Health and Human Services (HHS) Notice of Proposed Rulemaking (NPRM) on ACA-mandated Health Plan Certification. Get a Medicaid perspective on the positive impact the CAQH CORE Operating Rules are having on healthcare financial transactions. CAQH CORE National Webinar on Voluntary CORE Certification with Edifecs Thursday, November 6, 2014 | 2:00 - 3:30 pm ET Transforming Financial Transactions Through CAQH CORE Operating Rules: A Medicaid Perspective  Featuring: The Washington Healthcare Authority (HCA) and CNSI  Thursday, November 13, 2014 | 2:00 - 3:00 pm ET ___________________________________________________________________ CAQH CORE National Webinar on Voluntary CORE Certification with Edifecs  Thursday, November 6, 2014 | 2:00 - 3:30 pm ET Register for this event HERE for free Join CORE Phase III certified vendor organization, Orbograph, to hear about the benefits they are seeing after achieving Voluntary CORE Certification and get their tips on how you can also do the same. Receive information from CORE-authorized testing vendor, Edifecs, about their CORE-authorized Operating Rule testing platform and best practices for a successful Voluntary CORE Certification. Also, CAQH CORE will give an update on the actions we have taken to date related to theHHS NPRM on Health Plan Certification. _____________________________________________________________ Transforming Financial Transactions Through CAQH CORE Operating Rules: A Medicaid Perspective  Featuring: The Washington Healthcare Authority (HCA) and CNSI Thursday, November 13, 2014 | 2:00 - 3:00 pm ET Register for this event HERE for free Find out how the CAQH CORE Operating Rules are transforming healthcare financial transactions, with a focus on the significance of Medicaid involvement. TheWashington Healthcare Authority (HCA) and its partner, CNSI, will share their CAQH CORE Operating Rules implementation strategy, lessons learned and best practices in configuring its MMIS to ensure operational compliance. The team will share early operational metrics to help others get valuable insight into the significant gains achieved through Operating Rule implementation.

New Resources from CAQH CORE - Updated Versions of the CAQH CORE Enrollment Data Rules Now Available

New Resources from CAQH CORE Updated Versions of the  CAQH CORE Enrollment Data Rules Now Available The CAQH CORE Enrollment Data Task Group, which maintains the Enrollment Data Sets, has approved updated versions of the CAQH CORE 380: EFT Enrollment Data Rule and the CAQH CORE 382: ERA Enrollment Data Rule which include non-substantive adjustments to the Enrollment Data Sets only. These non-substantive adjustments improve usability of the Enrollment Data Sets by correcting typos and improving table formatting. Please Note: The non-substantive adjustments in v3.0.1 of the CAQH CORE 380 & 382 Rules DO NOT require entities to update their current EFT & ERA Enrollment Forms if they are already compliant with v3.0.0. New Webpage Dedicated to the  EFT and ERA Enrollment Data Sets Maintenance Process Click Here for Immediate Access! Here is our latest CAQH CORE resource - a free webpage to assist you with ongoing maintenance related to the Enrollment Data Sets in the CAQH CORE 380: EFT Enrollment Data Rule and the CAQH CORE 382: ERA Enrollment Data Rule. This webpage is a "one stop shop" for all needed tools and information to comply with CAQH CORE 380 & 382 Rules and the ongoing maintenance process. Highlights include: Access to current and past versions of the Enrollment Data Rules Timelines for updates and compliance Process for submitting potential adjustments Key considerations by stakeholder type Share this new link with colleagues responsible for EFT and ERA enrollment and provide us with any feedback on the usefulness of the site. NOTE: The CAQH CORE Enrollment Data Task Group maintains the Enrollment Data Sets and convened throughout the summer of 2014 to review the data sets and establish key policies for ongoing maintenance. Currently there are more than forty CORE Participant Organizations represented on the Task Group. Any CORE Participating Organization may join the Task Group and directly contribute to the maintenance process by emailing core@caqh.org. All entities are encouraged to join CAQH CORE; for more information on becoming a CORE Participating Organization click HERE.

CAQH PRESS RELEASE: Healthcare Organizations Voluntarily Earn More Than 150 CAQH CORE Operating Rules Certifications

CAQH distributed the following press release today. Contact CAQH atinfo@caqh.org for more information. CAQH PRESS RELEASE Healthcare Organizations Voluntarily Earn  More Than 150 CAQH CORE Operating Rules Certifications  Milestone Reflects the Added Value Certification  Brings to Operating Rules Implementation WASHINGTON, DC - Oct. 15, 2014 - The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today announced that healthcare organizations have voluntarily earned more than 150 CORE Certifications and many additional organizations have pledged to become CORE-certified. These commitments are a promising development in the drive to achieve interoperability through end-to-end adoption of healthcare operating rules. The CAQH CORE Operating Rules and voluntary Certification program are the result of an ongoing national collaboration among providers, health plans, vendors, associations, government entities, standard-setting organizations and others essential to improving claims-related transactions. Incorporating both data content and infrastructure, the operating rules enable high-quality, uniform data exchange across the healthcare system and support the integration of clinical and administrative data. "The full potential of operating rules is realized when everyone involved in the transaction is using the rules," explains George Conklin, chief information officer, CHRISTUS Health System and chair of the CAQH CORE multi-stakeholder board. "Like many organizations, CHRISTUS relies on vendor and trading partner systems to deliver the benefits of operating rules, enabling a coordinated data flow among health plans, vendors, and providers." CORE Certification promotes broader use of operating rules implementation and adds value by verifying that an organization operates in agreement with the rules and the underlying standards. It requires organizations to analyze and address how Operating Rules affect each of their trading partners. "We want healthcare providers to know that whenever they exchange administrative data they can depend on real-time access to information needed to make timely and informed decisions," says Howard Messing, CEO and President of MEDITECH, a software vendor and CHRISTUS Health trading partner that recently achieved CORE Certification. "Demonstrating compliance with the CAQH CORE Operating Rules through CORE Certification is essential to MEDITECH achieving that goal." CORE Certification was designed to be earned by all organizations - health plans, providers, vendors and clearinghouses - that can create, use or transmit administrative healthcare data. Working through Edifecs, the first CORE-authorized testing entity, certified organizations used a common set of test data to demonstrate that their systems can exchange information and return expected results with other systems as predicted by the operating rules and standards. CAQH CORE awards a Certification Seal that may be publicly displayed by those that successfully complete the certification process. A complete list of all CAQH CORE Certifications is available atwww.caqh.org/CORE_organizations.php. Recently awarded certifications include, A range of national, regional, self-insured, public and private health plans, such as: Blue Cross and Blue Shield of North Carolina Centene Corporation Florida Division of Medicaid Oklahoma Office of Management and Enterprise Services Employees Group Insurance Division Tufts Health Plan Vendor and Clearinghouse products that connect thousands of large and small providers, hospitals and health plans: athenahealth for athenaCollector MEDITECH for EDI Eligibility Validation - Version Client/Server 5.66 PaySpan for PaySpanHealth.com Trizetto Provider Solutions for Integrated Eligibility & Integrated Claim Status Inquiry As part of the Patient Protection and Affordable Care Act (ACA), operating rules are included in the Federal vision for health data interoperability. The Phase I, II and III CAQH CORE Operating Rules became federally mandated for HIPAA-covered entities after the Department of Health and Human Services (HHS) designated CAQH CORE as the authoring entity of those operating rules. Congress also asked HHS to require health plans, including those that are self-insured, to certify their compliance with the operating rules and underlying standards. Earlier this year, HHS drafted a proposal recommending health plans meet this certification requirement either by achieving CORE Certification or attesting that some form of testing has occurred by December 31, 2015. CAQH CORE offers a range of no-cost education programs to support implementation, end-to-end adoption, and certification of operating rules. Learn more at www.caqh.org. About CAQH CORE CAQH CORE is an industry-wide stakeholder collaboration committed to the development and adoption of national operating rules for administrative transactions. The more than 140 CORE Participants represent all key stakeholders, including providers, health plans, vendors, clearinghouses, government agencies, Medicaid agencies, banks and standard development organizations. To learn more about CAQH CORE, visit www.caqh.org. Follow us on Twitter: @caqh.

CAQH Solutions Webinar - Oct. 23, 2014 - Accelerating EFT Adoption with Providers

CAQH Solutions Informational Webinar Series  Accelerating EFT Adoption with Providers Thursday, October 23, 2014 | 1:00PM - 2:00PM ET REGISTER NOW There is no fee to attend Join CAQH and featured presenter, NACHA - The Electronic Payments Association, for an informational session on the value of electronic funds transfer (EFT) for both healthcare providers and health plans. This session will review the state of adoption for EFT and explore various ways that the industry is working together to improve interoperability across the healthcare system. Learning Objectives Investigate challenges for health plans and providers using current payment processes. Summarize current adoption levels of EFT. Describe the impact of the EFT standard and EFT and ERA Enrollment Operating Rules. Explore the benefits of the adoption of EFT via ACH. Discuss the need for interoperability and collaboration across the healthcare system. Identify existing options, such as the CAQH Solution, EnrollHub, that are working to support industry interoperability related to EFT. Presenters Ann Brisk, Director of Business Development at CAQH Priscilla Holland, NACHA - The Electronic Payments Association Who Should Attend Those responsible for provider reimbursements at a health plan, as well as anyone interested in learning more about CAQH solutions for the healthcare industry.   About NACHA NACHA serves as trustee of the ACH Network enabling payments such as Direct Deposit and Direct Payment via ACH. As a self-governing, collaborative rule maker and educator, NACHA helps to expand and diversify electronic payments, ensuring the Network remains universal and secure, creating value and enabling innovation for all participants. www.nacha.org  About CAQH CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients, and health plans. www.caqh.org

CAQH CORE Town Hall Call - Oct. 7, 2014 - Register Today

CAQH CORE October Town Hall Call DID YOU KNOW Updates Have Been Made That May Affect Your Organization's ACA Compliance? JOIN US to get the latest on key issues to ensure your organization's compliance with Federal Mandates, and hear Industry Information you cannot find anywhere else A Free Information Session Open to the Public Tuesday, October 7 2:00 - 3:00 pm ET Register HERE There is no fee to attend. Please join us for this 60-minute interactive session to get the latest information on CAQH CORE activities, including: CAQH CORE Operating Rule Maintenance Processes The latest CORE-required Code Combinations for the CORE-defined Business Scenarios v3.1.2 October 2014 became available on October 1, 2014 for use with the CAQH CORE 360: Uniform Use of CARCs and RARCs Rule. Your organization must be in compliance with this updated set by January 1, 2015. Learn about the changes to start your implementation. Draft HIPAA Credential Forms The draft HIPAA Credential forms developed by the CAQH CORE Certification and Testing Subgroup in response to the HHS Notice of Proposed Rule Making (NPRM) on ACA-mandated health plan certification were released on September 30, 2014. Let CAQH CORE walk you through the details of these updated forms and other actions taken by CAQH CORE related to the proposed HHS Rule. Third Set of ACA-mandated CAQH CORE Operating Rules CAQH CORE Participating Organizations are making considerable progress on the development of the draft third set of ACA-mandated Operating Rules. Hear about their work, receive an update on the status of this third set and find out how you can get involved in the Rule Development process. EFT & ERA Operating Rule Adoption CAQH CORE uses a number of internal and external sources to track industry adoption of EFT & ERA Operating Rules. Find out what we have learned from these sources about industry implementation progress, and get information about the latest transaction volumes. Q&A Take part in Q&A. Register Now to Reserve Your Spot for This Free Education Session CAQH CORE Town Hall Calls provide the public with an update on CORE's recent activities related to industry development and/or implementation of Federally mandated operating rules. This call is open to all non-CORE and CORE Participants and is for informational purposes only; no voting or decisions will occur. If you have any questions, please contact CORE@caqh.org.

Updated Version of CORE Code Combinations Available for Implementation

Updated Version Available for Implementation: October 2014 CORE Code Combinations v3.1.2 -  Includes Adjustments for 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 the CAQH CORE 360: Uniform Use of CARCs and RARCs Rule. The CAQH CORE 360 Rule 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 v3.1.2 October 2014 is now available on the CAQH CORE website for use with the CAQH CORE 360 Rule. The October 2014 CORE Code Combinations includes Compliance-based Adjustments as a result of code list updates published on July 1, 2014. A marked-up version of the October 2014 CORE Code Combinations showing the adjustments between v.3.1.1 and v.3.1.2 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.  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 the CAQH CORE 360 Rule and the ongoing maintenance process. This website page includes a summary of the updates and links to detailed updates. The CAQH CORE Code Combinations Task Group will launch its next Compliance-based Review in November to review updates from the code list authors that are scheduled for publication in November 2014. CORE Participants are encouraged to get involved with the Task Group. Beyond the Compliance-based Review, the Task Group has also begun planning to launch the annual Market-based Review in Fall 2014. Please do not hesitate to contact core@caqh.org with any additional questions.

CAQH CORE Publishes Updated Draft HIPAA Credential Forms

Updated Version Available for Implementation: October 2014 CORE Code Combinations v3.1.2 -  Includes Adjustments for 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 the CAQH CORE 360: Uniform Use of CARCs and RARCs Rule. The CAQH CORE 360 Rule 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 v3.1.2 October 2014 is now available on the CAQH CORE website for use with the CAQH CORE 360 Rule. The October 2014 CORE Code Combinations includes Compliance-based Adjustments as a result of code list updates published on July 1, 2014. A marked-up version of the October 2014 CORE Code Combinations showing the adjustments between v.3.1.1 and v.3.1.2 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.  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 the CAQH CORE 360 Rule and the ongoing maintenance process. This website page includes a summary of the updates and links to detailed updates. The CAQH CORE Code Combinations Task Group will launch its next Compliance-based Review in November to review updates from the code list authors that are scheduled for publication in November 2014. CORE Participants are encouraged to get involved with the Task Group. Beyond the Compliance-based Review, the Task Group has also begun planning to launch the annual Market-based Review in Fall 2014. Please do not hesitate to contact core@caqh.org with any additional questions.