CAQH CORE Announces Launch of 2015 Market-based Review for CORE Code Combinations

The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today launched the industry-wide submission period for the 2015 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. 2015 MBR INDUSTRY-WIDE SUBMISSION PERIOD The 2015 MBR will consider adjustments to the existing four CORE-defined Business Scenarios. Potential adjustments that can be submitted include additions, removals, or relocations to code combinations in the existing CORE-defined Business Scenarios based on evaluation criteria, usage data, and a strong business case. DUE DATE: Responses to the 2015 MBR must be received by 5pm ET onWednesday, 02/10/16. 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 2015 Market-based Adjustments Form.  GETTING STARTED: Eligible entities wishing to participate in the 2015 MBR can begin by completing Part 1 of the online form HERE.     ADDITIONAL RESOURCES: Detailed instructions to assist in the completion of the online 2015 Market-based Adjustments Form are available HERE. A sample completed CAQH CORE 2015 Market-based Adjustments Form is also available HERE for consultation as entities plan their submission.  Additionally, CAQH CORE education sessions will be offered announcing and explaining the MBR submission process.  NOTE: The CCTG is currently considering the 2014 industry submissions for potential new CORE-defined Business Scenarios. During its review of the 2014 new CORE-defined Business Scenario submissions, the CCTG will determine a later date to collect additional submissions for potential new CORE-defined Business Scenarios.   If you need additional assistance in navigating the Market-based Adjustments Form or have any questions regarding the 2015 MBR, please email core@caqh.org.