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.