CAQH certifies and awards CORE Certification Seals to entities that create, transmit or use the administrative transactions addressed by the CAQH CORE Operating Rules. CORE Certification means an entity has demonstrated that its IT system or product is operating in conformance with a specific phase(s) of the CAQH CORE Operating Rules. Voluntary CORE Certification is available for providers, health plans, clearinghouses, and product vendors.
Entities pursuing voluntary CORE Certification can become certified on just the Phase I CAQH CORE Operating Rules, both the Phase I & Phase II CAQH CORE Operating Rules, or the Phase I, Phase II, and Phase III CAQH CORE Operating Rules. Organizations that do not create, transmit, or use administrative healthcare transactions, and therefore cannot implement the CAQH CORE Operating Rules, are eligible to become CORE Endorsers.
Commitment to CORE Operating Rules
To receive a CORE Certification Seal, organizations must sign a binding pledge to adopt, implement and comply with CAQH CORE Operating Rules. By signing the CORE Certification Pledge, the organization commits to work with a CAQH CORE-authorized Testing Vendor to demonstrate that its product or IT system(s) are operating in accordance with the CORE rules. Testing must be completed within 180 days of signing the CORE Pledge. CORE testing and certification is tailored for providers, health plans, vendors and clearinghouses.