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Health Care Claims Subgroup

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Overview

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Staff

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Co-Chairs

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Members

Heather Morgan

Aetna

Cindy Monarch

Blue Cross Blue Shield of Michigan

Mike Denison

Change Healthcare

Ron Knapp

Blue Cross Blue Shield of Michigan

Kevin Chambers

virginia mason medical center

Heather McComas

American Medical Association (AMA)

Megan Soccorso

Gainwell Technologies

Randy Gabel

OhioHealth

Robert Otten

American Medical Association (AMA)

Tracey Tillman

The SSI Group, Inc.

Terrence Cunningham

American Hospital Association (AHA)

Susan Langford

BlueCross BlueShield of Tennessee

Tonia Bateman-Wold

New Mexico Cancer Center

Michelle Barry

Availity, LLC

Carl Siebers

Blue Cross Blue Shield of Michigan

Gail Kocher

Blue Cross and Blue Shield Association (BCBSA)

Linda Reed

St. Joseph Health

Erin Weber

CAQH

Teresa Strickland

NCPDP

Bob Bowman

CAQH CORE

Patricia Wijtyk

Cognizant

Michael Phillips

CAQH CORE

Cynthia Mueller

UnitedHealthgroup

Rebecca Jones

Optum Insight

Lisa Ness

virginia mason medical center

Nancy Team

NextGen Healthcare Information Systems, Inc.

Mahesh Siddanati

Centene

Rose Hodges

Aetna

Daniel Hanna

Healthedge Software Inc

Rachel Foerster

Rachel Foerster & Associates

Tammy Vicari

TCS

Mark Rabuffo

Aetna

Heather Sammons

BCBSNC

Kiran Kalluri

Unitedhealthcare

Jameelah O'Neal

Medical Mutual of Ohio

Nora Iluri

Athena Health

Juneko Kay-Rast

NextGen

Robert Tennant

Work Group for Electronic Data Interchange (WEDI)

Tara Rose

Optum

Kayla Cooper

CAQH

Gheishaly Rosariodiaz

LabCorp

Kathy Sites

Availity

Nikita Willams-Woods

Tata Consultancy Services

Jenny Wallace

Virginia Mason Medical Center

Marianne Davidson

Aetna

Nancy Spector

American Medical Association (AMA)

Kristen Bolam

Aultcare

Leah Barber

Availity

Joshua Jordan

Availity

Fred Rooke

Centers for Medicare and Medicaid Services (CMS)

Pauny Rezai

Kaiser Permanente

Mary Alexander

Ohio Health

Pete Benziger

CAQH CORE

Erica Martin

AMA

Scott Wanless

Ameritas

Chris Criswell

AultCare

Christina Love

Availity

Rebecca Barnes

Availity

Amy Rasegan

BCBS- Michigan

Natasha Sallie

BCBS- Michigan

Steve Cloutier

BCBS- Michigan

Betty Harris

BCBS- NC

Jeff Narog

Cigna

Brian Pickens

BCBS- IL

Olga Khabinskay

Healthcare Business Management Association

Robert Irvine

HEALTHeNET

Athalage Bandula

Horizon Blue Cross Blue Shield of New Jersey

Penny Lewnes-King

Horizon Blue Cross Blue Shield of New Jersey

Robert Bigham

Kaiser Permanente

John Moreno

NextGen Healthcare Information Systems, Inc.

Lynne Chapple

OptumInsight- UnitedHealth Group

Andreq Shulz

Cognizant

Laurie Dean

UnitedHealth Group

Claire Jarvis

UnitedHealth Group

Sofia Fayazdee

UnitedHealth Group

Terri Cook

UnitedHealth Group

Thuy VoHusmann

Anthem

Anitha Aerabati

AIM Specialty Health

Dave Sheldon

Healthedge Software Inc

Tonya Lane

Healthedge Software Inc

Jamie Osborne

Children's Healthcare of Atlanta Inc

Mona Patel

Point32 Health

Michael Sherman

Point32 Health

Nicole Williams

Cognizant

Akila Kumaresan

Cognizant

Vincent Carillo

Cognizant

Navin Rangarajan

Cognizant

Tania Mason

Cognizant

Brian Petry

TRICARE

Andrea Preisler

American Hospital Association

Linda Milton

Optum

Russell Werth

Point32 Health

Jennifer Bussone

BCBS- Michigan

Michelle Medina

Cleveland Clinic

Robert Jones

Cleveland Clinic

Sanjeev Suri

Cleveland Clinic

Elly Cullen

athenahealth

Ani MacNulty

athenahealth

Margaret Schuler

Aspen Dental

Erin Miller

Montefiore Medical Center

Emidio Depina

athenahealth

James Haberman

Epic

Benjamin Tarmann

Epic

Meredith Ray

Cigna

Cheryl Mallory

PeaceHealth

Genevieve Morris

Change Healthcare

Shawn Stack

HFMA

Rene Woerner-Utley

OSF Healthcare

Loleta Bethea

Kaiser Permanente

Cyndi Padilla

Cognizant

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Documents

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CAQH CORE_Health Care Claims Subgroup_Meeting 6 Call Summary_09.21.23

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CORE Health Care Claims (837) Data Content Rule_09.21.23

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CORE Claim Acknowledgment (277CA) Data Content Rule_09.21.2023

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CORE-required Code Combinations for CORE-defined Claim Rejection Business Scenarios.09.21.23

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Doc #2: CAQH CORE_Health Care Claims Subgroup_Meeting 5 Call Summary_08.24.23

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Doc #1: CAQH CORE_ Health Care Claims Subgroup_Meeting 6_09.21.2023

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CAQH CORE 277CA Error Code Combinations_8.29.23

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CAQH CORE_Health Care Claims Subgroup Meeting 4 Call Summary_07.27.23

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CAQH CORE_Health Care Claims Subgroup_Meeting 5_08.24.23

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CAQH CORE 277CA Error Code Combintations_08.24.23

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HC Claims Subgroup Straw Poll 3 Non-Sub Comments 06.22.23

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CAQH CORE_Health Care Claims Subgroup_Meeting 4_07.27.23

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CAQH CORE_Health Care Claims Subgroup_Meeting 2 Call Summary_05.04.23

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CAQH CORE_ Health Care Claims Subgroup_Meeting 3_06.22.2023

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Doc #3 CORE - HC Claims Issue Brief Final

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Doc #2 Health Care Claims Subgroup Meeting 1 Call Summary 04.13.23

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Doc #1 Health Care Claims Subgroup Meeting 2 Deck 05.04.23

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Doc #4 HC Claims Subgroup Straw Poll 1 Non-Sub Comments 05.04.23

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CAQH CORE Health Care Claims Subgroup Meeting 1 Slides

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CAQH CORE Health Care Claims Focus Group Straw Poll Results

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