Type | Standard / Implementation Specification | Standards Process Maturity | Implementation Maturity | Adoption Level | Federally required | Cost | Test Tool Availability |
---|---|---|---|---|---|---|---|
Operating Rules
|
Final
|
Production
|
![]() |
No
|
Free
|
Yes
|
Limitations, Dependencies, and Preconditions for Consideration |
Applicable Security Patterns for Consideration
|
---|---|
|
Comment
Submitted by doodles531
on 2020-12-12
Submitted by jporras on 2020-11-01
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 RulesISA Comments from CAQH CORE 11.1.20 FINAL_4.pdf