The CAQH® CORE® Operating Rules described on this page have been finalized and approved by CAQH® CORE® and its participating members for voluntary adoption and certification. They are not mandated by federal law.
For more information on CAQH® CORE® voluntary certification, see https://www.caqh.org/core/core-certification-process.
Change Healthcare has obtained CAQH® CORE® voluntary certification for the Eligibility & Benefit, Claim Status, and Payment & Remittance Operating Rules. See Change Healthcare Accreditations & Certifications for additional information.
The table below shows all voluntary operating rules.
No federal regulation has been issued adopting the operating rules described on this page; however, the National Committee on Vital and Health Statistics (NCVHS) conducted hearings on prospective adoption in 2016 and again in 2020. After these hearings, the NCVHS recommended against federal mandate of these rules, but encouraged the industry to pursue voluntary adoption.
NCVHS letters of recommendation are available here:
X12 manages the exclusive copyright to all X12 standards, publications, and products; see https://x12.org/products/ip-use for details. The X12 TR3 that details the full requirements for this transaction can be licensed at https://x12.org/licensing.
CORE®, the CORE-certification/Endorser Seals and logo are registered trademarks of CAQH®, copyright 2021, Council for Affordable Quality Healthcare®.