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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

Tonya Moffitt

Availity, LLC

Heather McComas

American Medical Association (AMA)

Donna Campbell

Health Care Service Corporation

Megan Soccorso

Gainwell Technologies

Brad Smith

NACHA The Electronic Payments Association

Terrence Cunningham

American Hospital Association (AHA)

Susan Langford

BlueCross BlueShield of Tennessee

Michelle Barry

Availity, LLC

Daniel Kalwa

Centers for Medicare and Medicaid Services (CMS)

Daniel Saunders

Cognosante

Cristina Boincean

Edifecs

Erin Weber

CAQH

Diana Fuller

State of Michigan Medicaid

Chuck Veverka

State of Michigan Medicaid

Bob Bowman

CAQH CORE

Patricia Wijtyk

Cognizant

Dawn Duchek

Trizetto Provider Solutions

Chris Queen

HIVE Strategy

Nancy Team

NextGen Healthcare Information Systems, Inc.

Margaret Weiker

National Council for Prescription Drug Programs (NCPDP)

Rose Hodges

Aetna

Taha Anjarwalla

CAQH CORE

Kaitlin Powers

CAQH CORE

Mark Rabuffo

Aetna

Heather Sammons

BCBSNC

Kristina Steece

Ameritas

Robert Tennant

Work Group for Electronic Data Interchange (WEDI)

Tara Rose

Optum

Nihal Titan

Claim.MD

Kayla Cooper

CAQH

Gheishaly Rosariodiaz

LabCorp

Marianne Davidson

Aetna

Nancy Spector

American Medical Association (AMA)

Charles Hawley

National Association of Health Data Organizations (NAHDO)

Mary Alexander

Ohio Health

Erica Martin

AMA

Brian Pickens

BCBS- IL

Athalage Bandula

Horizon Blue Cross Blue Shield of New Jersey

Lynne Chapple

OptumInsight- UnitedHealth Group

Mary Sussman

Tata Consultancy Services

Era Rodriguez

AHCCCS

Andrea Preisler

American Hospital Association

Margaret Schuler

Aspen Dental

Emidio Depina

athenahealth

James Haberman

Epic

Benjamin Tarmann

Epic

Meredith Ray

Cigna

Christopher Gracon

HealtheNet

Marie Becan

PeaceHealth

Shawn Stack

HFMA

Katie Gilfillan

HFMA

Stephanie Farley

United States Department of Veterans Affair

Kristin Thonsgaard

Optum Insight

Kellene Parthemore

Aetna

Mark Warren

Aetna

Noah Mastel

Ameritas

Margaret Kutz

Elevance Health

Christol Green

Elevance Health

Nathaniel Boer

Change Healthcare

Everet Ford

Optum

Rene Utley

OSF Healthcare

Mona Patel

Poin32

Nina Boldosser

SS&C Health

Holly Gilligan

UnitedHealthcare

Matt Burkhard

Aetna

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Documents

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FOR RWG BALLOT: CORE Health Care Claims Operating Rules At-a-Glance

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FOR RWG BALLOT: CORE EFT & ERA Enrollment Data Operating Rules At-a-Glance

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FOR RWG BALLOT: CORE Payment & Remittance ERA Enrollment Data Rule

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FOR RWG BALLOT: CORE VBP Rules At-a-Glance

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FOR RWG BALLOT: EFT & ERA Enrollment Data Test Scenarios

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FOR RWG BALLOT: CORE-required Maximum EFT Enrollment Data Set Companion Document

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FOR RWG BALLOT: CORE-required Maximum ERA Enrollment Data Set Companion Document

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FOR RWG BALLOT CORE Payment & Remittance EFT Enrollment Data Rule

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FOR RWG BALLOT: CORE Claim Acknowledgment Certification Test Scenarios

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FOR RWG BALLOT: Draft Attributed Patient Roster Certification Test Scenarios

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FOR RWG BALLOT: Draft Benefit Enrollment Certification Test Scenarios

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FOR RWG BALLOT: CORE Health Care Claims Certification Test Scenarios

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FOR RWG BALLOT: CORE Health Care Claims (837) Data Content Rule_vHC.1.0

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FOR RWG BALLOT: CORE Claim Acknowledgment (277CA) Data Content Rule_vCA.1.0

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FOR RWG BALLOT: CORE-required Error Code Combinations for CORE-defined Claim Rejection Business Scenarios

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IV. CORE Attributed Patient Roster Infrastructure Rule_vAPR3.0

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III. CORE Attributed Patient Roster Data Content_vAPR2.0

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II. CORE Benefit Enrollment and Maintenance Infrastructure Rule_vBE.3.0

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I. CORE Benefit Enrollment and Maintenance Data Content Rule vBEM.1.0

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CORE Framework for Semantic Interoperability in Value-based Payments Version SI.1.0

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Best Practices Identified by CORE Participants for the Collection and Exchange of Sociodemographic Information

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Doc #1 RWG Call 4 Slide Deck 12.14.23

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Doc #2 RWG Call 3 Summary 11.16.23

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Doc #3 RWG Non-Substantive Comments Received on Straw Poll 3

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For Straw Poll #3 CORE-required Maximum ERA Enrollment Data Set Companion Document

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For Straw Poll #3 CORE-required Maximum EFT Enrollment Data Set Companion Document

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For Straw Poll #3 DRAFT CORE Payment and Remittance ERA Enrollment Data Rule

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For Straw Poll #3 DRAFT CORE Payment and Remittance EFT Enrollment Data Rule

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For Straw Poll #3 DRAFT EFT & ERA Enrollment Data Certification Test Scenarios

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Doc #2 RWG Call 2 Summary 10.19.23

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Doc #1 RWG Call 3 Deck 11.16.23

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IV. DRAFT Health Care Claims Data Content CORE Certification Test Scenarios

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II. CORE Claim Acknowledgment Data Content Rule_RWG_10.19.2023

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I. CORE Health Care Claims Data Content Rule_RWG_10.19.2023

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III. CORE-required Error Code Combinations for CORE-defined Claim Rejection Business Scenarios_RWG_10.19.2023

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Doc #2 RWG Call 1 Summary 09.14.23

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Doc #1 RWG Call 2 Deck 10.19.23

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VI. DRAFT Value-based Payment CORE Certification Test Scenarios

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V. CORE Framework for Semantic Interoperability_RWG_09.25.2023

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IV. CORE Attributed Patient Roster Infrastructure Rule_RWG_09.25.2023

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III. CORE Attributed Patient Roster Data Content_RWG_09.25.2023

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II. CORE Benefit Enrollment and Maintenance Infrastructure Rule_RWG_09.25.2023

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I. CORE Benefit Enrollment and Maintenance Data Content Rule_RWG_09.25.2023

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Doc #1 RWG 1 Call Deck 09.14.23

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