The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) comply with the CAQH CORE, EFT and ERA Operating Rule Set developed by the Department of Health and Human Services (DHHS) as part of the Affordable Care Act (ACA) – with attention to CARC/RARC and CAGC combinations.
Subject: Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) Committee on Operating Rules for Information Exchange (CORE)
Release Date: November 9, 2017
Effective Date: April 1, 2018
Implementation Date: April 2, 2018
Special Notes: N/A