Operating Rules for Prior Authorization and Referrals

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CAQH CORE Comments to ONC ISA - Phase V

Aligning ISA with New Operating Rule Structure: In Spring 2020, CAQH CORE restructured its operating rules from phase-based rule sets to rule sets based on the business processes supported by the rules. No substantive changes were made to existing rule requirements. As a result of the restructuring, CAQH CORE recommends updates to the following sections of the ISA: Operating Rules for Prior Authorization (Phase V) -- Prior Authorization & Referrals Operating Rules

ISA Comments from CAQH CORE 11.1.20 FINAL_4.pdf

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