Integration & Interoperability News

CAQH CORE Releases Guidelines to Improve Information Exchange

The new operating rules aim to streamline how healthcare providers exchange information, optimize workflow, and support better administration operations.

Industry approved guidelines support better administrative operations and information at the point of care.

Source: Getty Images

By Sarai Rodriguez

- CAQH CORE, the author of national operating rules for the HIPAA-covered administrative transactions, recently released new operating rules to enhance information exchange and healthcare operations related to benefits coverage and supplemental documentation.

"The operating rules released today represent another step in improving the way plans, and providers exchange information millions of times every day," Tim Kaja, senior vice president, Optum Care, and CAQH CORE board chair, said in a press release. "These rules will improve operations — in administrative offices and at the point of care — and will enhance the experience for all stakeholders."

The new CAQH CORE Attachments Operating Rule aims to improve the exchange of attachments, a long-standing industry issue. The guidelines will establish key infrastructure and data content requirements, helping providers send electronic health plans documentation to support a claim or prior authorization in a uniform format, the press release stated.