CAQH CORE: December 2014

Tuesday, December 23, 2014

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

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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. 

Thursday, December 18, 2014

CAQH CORE National Webinars - January 2015 Education Events

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CertificationJoin CORECORE PIFAQsAboutContact 
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.
Wednesday, January 14, 2015 | 2:00 - 3:30 pm ET
Featuring Emory Health 
Thursday, January 22, 2015 | 2:00 - 3:00 pm ET
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jumpJumpstart 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.
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providerStreamlining 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.