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FAQs

CAQH CORE offers Frequently Asked Questions (FAQs) addressing all of the CAQH CORE Operating Rules, general CAQH CORE information, CORE Certification and future development of operating rules. You may find your FAQ by clicking on the links below or using the search bar above to identify key words.

The following FAQs are for informational purposes only; in the case of a discrepancy between the FAQs and CAQH CORE Operating Rule text and/or Federal regulations, the latter take(s) precedence.

FAQ Categories

Part A: ACA Section 1104 Mandate for Federal Operating Rules
Part B: CAQH CORE Connectivity
Part C: CAQH CORE Eligibility & Benefits Operating Rules
Part D: CAQH CORE Claim Status Operating Rules
Part E: CAQH CORE Payment & Remittance Operating Rules
Part F: CAQH CORE Prior Authorization & Referrals Operating Rules
Part G: CAQH CORE Health Care Claims Operating Rules
Part H: CAQH CORE Benefit Enrollment Operating Rules
Part I: CAQH CORE Premium Payment Operating Rules
Part J: Certification: CORE Certification, CORE Recertification, and CORE Endorsement
Part K: CAQH CORE Attributed Patient Roster Operating Rules
Part L: CAQH CORE Framework for Semantic Interoperability in Value-based Payments