Overview of the CAQH CORE Prior Authorization Operating Rules Submitted to NCVHS

As the Operating Rule Authoring Entity for the HIPAA-mandated electronic transactions, CAQH CORE has submitted for review a set of prior authorization and connectivity operating rules for federal adoption by the National Committee on Vital and Health Statistics (NCVHS). The rules include provisions regarding data content, infrastructure, and connectivity for the exchange of the X12/005010X217 Health Care Services Review – Request for Review and Response (278). NCVHS is gathering comments to make recommendations regarding the proposed rules to the federal Secretary of Health and Human Services.

This webinar will serve as an overview of the proposed prior authorization and connectivity operating rules. WEDI will be holding a virtual Policy Advisory Group (PAG) on July 16th to gather comments that WEDI will be submitting to NCVHS regarding these operating rules. 

The presenters for this webinar include Erin Weber, Director, CORE at CAQH and April Todd, Senior Vice President at CAQH.