RFI - Health Plan Identifier: Action Model Letter Development

Good afternoon, The U.S. Department of Health and Human Services (HHS) is seeking comments on a Request for Information (RFI) on the Health Plan Identifier (HPID). The comments are due to HHS by July 28th, 2015. The RFI asks for comments  on the following three issues regarding the HPID: The HPID enumeration structure outlined in the HPID final rule, including the use of the CHP/SHP and OEID concepts ["HPID Enumeration Requirements"]. The use of the HPID in HIPAA transactions in conjunction with the Payer ID["HPID Use Requirements"]. Whether changes to the nation's health care system, since the issuance of the HPID final rule published September 5, 2012, have altered your perspectives about the function of the HPID. CAQH CORE will develop a model letter which entities can use at their discretion. CAQH CORE will take several steps, as it has in the past when HHS regulatory action called for public comments, to produce this model letter. Those steps are as follows: Activity Date of Event Open CAQH CORE call regarding key themes and questions (Registration for open call available HERE; potential themes and questions to be posted on CAQH CORE website. Should you have a position you would like to share, please send tocore@caqh.org by June 30th)  July 1, 2015 3 - 4 pm ET CAQH CORE Participant call to discuss Draft Model Letter (Registration for call available HERE; Draft letter will be posted prior to call on CAQH CORE website. Should you have a position or draft letter you would like to share, please send tocore@caqh.org by July 14th) July 15, 2015 3 - 4 pm ET Final Model Comment Letter (Final model letter will be posted on CAQH CORE website and sent via email. The CAQH CORE Board will be submitting a final CAQH CORE letter by July 28th.) July 21, 2015 Please join CAQH CORE to share your input on this important effort. For any questions, please reach out to the CAQH CORE staff at CORE@caqh.org. Thank you, CAQH CORE Staff

June 25th CAQH CORE Voluntary Certification National Webinar with MEDITECH and Edifecs

CAQH CORE VOLUNTARY CERTIFICATION NATIONAL WEBINAR WITH MEDITECH AND EDIFECS THURSDAY, JUNE 25, 2015   2:00-3:00 PM ET REGISTER NOW There is no fee to attend. Roadmap to HIPAA Conformance: Is CORE Certification right for your Organization? An EHR Vendor Perspective Why would one of the nation's largest electronic health record vendors become CORE Certified? Join us on June 25th to learn about industry-leader MEDITECH's motivation and get an insider look at the process from this recent certifier. Learn what stakeholder types would benefit most from CORE Certification, and get helpful tips from CORE-authorized Testing Vendor EDIFECS. What will you learn? MEDITECH representatives will describe their recent experience with the CORE Certification process, including their best practices and lessons learned, and what they see as the benefits of implementing the CAQH CORE Operating Rules and becoming CORE Certified. CAQH CORE staff will explain the value to your organization in using voluntary CORE Certification to help verify that your systems or products conform with the federally mandated Operating Rules, and how to identify your appropriate stakeholder category for maximum testing and certification success. EDIFECS will showcase its CORE-authorized testing site and offer tips on how to ensure that the CORE Certification testing process goes smoothly. Who Should Attend All entities are welcome to attend this educational webinar. If you have questions, please contact CORE@caqh.org. NOTE: The CAQH webinar service provider has increased its security requirements. You will no longer be able to use Internet Explorer version 8.0 or older to access CAQH webinars. Please visit the CAQH Webinar webpage for additional options, including how to test your system to ensure it meets the new requirements. 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 CORE Code Combinations June 2015

Updated Version Available for Implementation: June 2015 CORE Code Combinations v3.2.0 -  Includes Adjustments for 2014 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 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 amaximum 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 v3.2.0 June 2015 is now available on the CAQH CORE website for use with the CAQH CORE 360 Rule. The June 2015 CORE Code Combinationsincludes: Compliance-based Adjustments as a result of code list updates published on March 1st and April 15th Market-based Adjustments to the existing four CORE-defined Business Scenarios based upon the 2014 Market-based Review A marked-up version of the June 2015 CORE Code Combinations showing both Compliance-based and Market-based Adjustments between v.3.1.3 and v.3.2.0 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. 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. In July, the CAQH CORE Code Combinations Task Group will launch its next Compliance-based Review in order to review updates from the code list authors that are scheduled for publication in July 2015. During this review cycle, the Task Group will also complete its Market-based Review of the potential new CORE-defined Business Scenarios submitted via the Industry-wide CAQH CORE 2014 Market-based Adjustments Form. CAQH CORE Participants are encouraged to get involved with the Task Group. Please do not hesitate to contact core@caqh.org with any additional questions.

Register for the CAQH CORE June 9 Town Hall National Webinar

Join Us for the CAQH CORE June Town Hall National Webinar A Free Information Session Open to All Stakeholders Tuesday, June 9 2:00 - 3:00 pm ET    Register HERE There is no fee to attend.      Please join us for our quarterly Town Hall Call, a 60-minute interactive session to get the latest information on CAQH CORE and related CAQH activities, including: Progress on CAQH CORE Phase IV Operating Rules Development Receive insights about continuing progress on the development of the Phase IV CAQH CORE Operating Rules to address the remaining ACA mandates and learn about the process toward final balloting as well as the Phase IV Test Suite.  CAQH CORE Code Combination Maintenance Processes and Market-based Review CAQH CORE continues its maintenance process of the ERA Code Combinations. Hear updates on this important maintenance process, including the recently completed Market-based Review, and how you can join this ongoing effort. Voluntary CORE Certification Update As we surpass the 180 CORE Certifications milestone, get an update on Voluntary CORE Certification and hear about recently certified entities. CAQH CORE Board Activities and NCVHS as the ACA Review Committee Learn about recent CAQH CORE Board activities and what CAQH CORE is doing to prepare for the NCVHS Subcommittee on Standards ACA Required Review Committee hearing. Upcoming 2015 Education Sessions Hear about upcoming CAQH CORE webinar topics. Q&A Take part in Q&A. Register 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 COREWEBINAR@caqh.org. The CAQH webinar service provider has increased their security requirements. You will no longer be able to use Internet Explorer version 8.0 or older to access CAQH webinars.  Please visit the CAQH Webinar webpage for additional options, including how to test your system to ensure it meets the new requirements.

Register for the CAQH CORE June 9 Town Hall National Webinar

Join Us for the CAQH CORE June Town Hall National Webinar A Free Information Session Open to All Stakeholders Tuesday, June 9 2:00 - 3:00 pm ET    Register HERE There is no fee to attend.      Please join us for our quarterly Town Hall Call, a 60-minute interactive session to get the latest information on CAQH CORE and related CAQH activities, including: Progress on CAQH CORE Phase IV Operating Rules Development Receive insights about continuing progress on the development of the Phase IV CAQH CORE Operating Rules to address the remaining ACA mandates and learn about the process toward final balloting as well as the Phase IV Test Suite.  CAQH CORE Code Combination Maintenance Processes and Market-based Review CAQH CORE continues its maintenance process of the ERA Code Combinations. Hear updates on this important maintenance process, including the recently completed Market-based Review, and how you can join this ongoing effort. Voluntary CORE Certification Update As we surpass the 180 CORE Certifications milestone, get an update on Voluntary CORE Certification and hear about recently certified entities. CAQH CORE Board Activities and NCVHS as the ACA Review Committee Learn about recent CAQH CORE Board activities and what CAQH CORE is doing to prepare for the NCVHS Subcommittee on Standards ACA Required Review Committee hearing. Upcoming 2015 Education Sessions Hear about upcoming CAQH CORE webinar topics. Q&A Take part in Q&A. Register 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 COREWEBINAR@caqh.org. The CAQH webinar service provider has increased their security requirements. You will no longer be able to use Internet Explorer version 8.0 or older to access CAQH webinars.  Please visit the CAQH Webinar webpage for additional options, including how to test your system to ensure it meets the new requirements.

CAQH CORE Open Mic 5/28 on Survey to Provide Input on Operating Rules

CAQH CORE OPEN MIC SESSION THURSDAY, MAY 28, 2015 2:00 - 3:00 PM ET REGISTER NOW There is no fee to attend. Provide Input on Current Operating Rule Opportunities, Barriers and Value for CAQH CORE June Testimony to the Affordable Care Act (ACA) Review Committee Purpose of the Open Mic CAQH CORE is offering this opportunity to provide input to the upcoming first hearing of the Standards and Operating Rules Review Committee on June 16-17, 2015. Under the auspices of the National Committee on Vital Health Statistics, the ACA-established Review Committee will consider existing health care administrative transactions for which standards or operating rules already exist and are in use and, if needed, make recommendations to HHS for update or improvement. CAQH CORE is collecting industry information using a survey tool that will be discussed in detail during the session. NOTE: This webinar will be the same format as the May 19th webinar.  If you have already submitted the survey or attended the May 19th webinar, you do not need to attend this webinar. Who Should Attend This webinar is designed for both CORE and non-CORE participating organizations and entities who are interested in learning about and completing the CAQH CORE survey on current operating rule opportunities, barriers and value for the June testimony before the Affordable Care Act (ACA) Review Committee. CAQH CORE SURVEY Click here to complete survey -- Deadline is June 2, 2015 by 5:00 PM ET Purpose of the Survey CAQH CORE needs your survey responses to ensure that the currently adopted (Eligibility, Claim Status, ERA, and EFT) operating rules for the HIPAA transactions continue to meet industry needs. Results from this survey will contribute to the testimony which CAQH CORE is presenting to the ACA Review Committee on June 16-17, 2015. Your input will also impact CAQH CORE work on operating rules in the future. Survey Scope The questions in this survey relate only to the operating rules and not the underlying standards which the operating rules support. The survey relates only to the operating rules which are currently adopted for use (Eligibility, Claim Status, ERA, and EFT), as that is the scope of the ACA Review Committee. There are just 20 multiple choice survey questions (should take 5-15 minutes to complete). 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. Also, join us for the CAQH CORE June 9th Town Hall Webinar Tuesday, June 9, 2015  2:00-3:00 PM ET Register HERE CAQH CORE Town Hall Webinars 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.

CAQH CORE Survey -- Provide Input on Current Operating Rules

CAQH CORE SURVEY Give Us Your Input on Current Operating Rule Opportunities, Barriers and Value for Our June Testimony Before the Affordable Care Act (ACA) Review Committee Click here to complete survey Deadline is June 2, 2015 by 5:00 pm ET Purpose of the Survey We need your survey responses to ensure that the currently adopted (Eligibility, Claim Status, ERA, and EFT) operating rules for the HIPAA transactions continue to meet industry needs. Results from this survey will contribute to the testimony which CAQH CORE is presenting to the ACA Review Committee on June 16-17, 2015. Your input will also impact CAQH CORE work on operating rules in the future.  Survey Scope The questions in this survey relate only to the operating rules and not the underlying standards which the operating rules support. The survey relates only to the operating rules which are currently adopted for use (Eligibility, Claim Status, ERA, and EFT), as that is the scope of the ACA Review Committee. There are just 20 multiple choice survey questions (should take 5-15 minutes to complete). To learn more about the survey, click here to listen to a May 19th special webinar audiocast or review the slide deck. Background Under the auspices of the National Committee on Vital Health Statistics (NCVHS), the ACA established Review Committee will: Review currently adopted standards, operating rules, code sets and identifiers used in each of the HIPAA-named administrative simplification transactions and evaluate the degree to which they meet current industry business needs, and, if needed, make recommendations to HHS for update or improvement. Identify transactions, standards, operating rules, code sets and identifiers used in administrative simplification that require changes, deletions or new versions in order to meet industry needs. 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.