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THE PHASE II RULES

 

CORE Phase II
Scope and Rules

 

For questions or to learn how to provide feedback on draft rules, contact CAQH.


CORE Overview Presentation


CORE Provider Presentation

CORE Phase I Fees

Clearinghouses
Below $75 million in net annual revenue:$4,000
$75 million and above in net annual revenue:$6,000

Health Plans
Below $75 million in net annual revenue:$4,000
$75 million and above in net annual revenue:$6,000
Vendors
Below $75 million in net annual revenue:$4,000
$75 million and above in net annual revenue:$6,000
Providers
Up to $1 billion in net annual revenue:$500
$1 billion and above in net annual revenue:$1,500

Endorsers
(Only entities that do not create, transmit or use eligibility data)No Fee


NOTES:

  • There is no charge to Federal or State government entities to receive the CORE Seal.
  • There is no charge to CAQH member plans to receive the CORE Seal.
  • Participants in the Phase I Early Adopters Measures of Success program will receive a 50% Seal discount. (Organizations must be certified by July 31, 2006, and be selected by CAQH to participate in the program to receive the discount.)
  • This fee is a one-time cost for Phase I certification, unless an entity becomes decertified or if major changes to the rules are approved by a full CORE vote (Reference CORE 102: Eligibility and Benefits Certification Policy).
  • The CORE Certification Seal fee does not include the fee for CORE certification testing, which is standard for each stakeholder type. The CAQH website - www.caqh.org – can be accessed for a list of CORE-authorized testing companies and their associated testing fees.
  • CORE participation and CORE certification are two separate activities. If you are interested in participating in CORE, review the CORE Participant Application. CORE participants can assist with writing the rules/policies in addition to voting on the next phase of rules.