CAQH CORE Announces New
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National Healthcare Operating Rules
Health plans, healthcare providers, and the clearinghouses and vendors that support them, now have national operating rules to improve how they can work together as trading partners. The voluntary operating rules will help streamline the electronic data exchange of four more healthcare business transactions: healthcare claims; prior authorization; employee premium payment; and enrollment and disenrollment in a health plan.
CAQH CORE recently announced that the Phase IV CAQH CORE Operating Rules package has been approved and the industry should begin coordinating voluntary implementation. Reaching this milestone is the result of enormous effort by the multi-stakeholder CAQH CORE collaboration, which includes a wide range of public and private entities.
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