HTTPS CAQH CORE compliant connectivity guide 2/11/20, 10'20 PM

Last Modified: 5/24/2019 Location: FL, PR, USVI Business: Part A, Part B
First Coast Service Options, Inc. (First Coast) HTTPS CAQH CORE compliant
connectivity guide
Introduction
The Secretary of the Department of Health and Human Services (HHS) named the Council for Affordable Quality
Healthcare (CAQH) Committee on Operating Rules (CORE) as the authoring entity of the phase I, II, and III operating
rule. The operating rules are intended to provide additional direction and clarification to the electronic data interchange
(EDI) standard adopted under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
This document provides information on how to connect to the First Coast JN M2 Smartxfr CAQH CORE compliant system
server that supports the following two message envelope standards and message exchanges, hypertext transfer protocol
& multipurpose internet mail extensions (HTTP+MIME) and simple object access protocol & web service definition
language (SOAP+WSDL) message, in accordance with the CAQH CORE phase II connectivity rule 270. Go to
http://www.caqh.org/pdf/CLEAN5010/270-v5010.pdf for information on the CAQH CORE connectivity rule 270 version
2.2.0. For additional information on the CAQH CORE rules visit http://www.caqh.org/core .
User expectations
This document is intended for use by a technical professional or an organization that has experience implementing
secure web-based connectivity. The instructions in this guide are not intended to stand alone as a sole resource.
It is solely the responsibility of the submitter or user to develop and create their CORE web services compliant client
application. First Coast will not provide or support the end user client application. First Coast strongly recommends the
organizations using this guide to take appropriate actions and have available technical support before attempting to enroll
using the HTPPS CAQH CORE connection.
Please ensure you are using Soap Envelope Version 1.2 and SOAP Message Version 1.2. Also make sure you are using
Transport Security Mode with Certificate Authentication.
Enrollment
Trading partners are required to enroll prior to attempting to connect to the First Coast JN M2 Smartxfr CAQH CORE
compliant system. To access the new EDI HTPSS CAQH core connection enrollment form visit
https://medicare.fcso.com/EDI_Forms/.
For more information on how to enroll for HTTPS CAQH CORE compliant connection for EDI please contact the First
Coast EDI helpdesk at 888-670-0940 or via email to MedicareEDI@fcso.com.
X.509 digital certificate
The purchase of a X.509 digital certificate from a trusted certificate authority is a requirement in order to connect to the
First Coast JN M2 Smartxfr CAQH CORE compliant system. The X.509 digital certificate must be recertified at intervals
defined by the Certificate Authority in order to continue to access the First Coast JN M2 Smartxfr CAQH CORE compliant
system. Trading Partners will need to authenticate with an X.509 digital certificate as user ID and password authentication
will not be supported.
The trading partners X.509 digital certificate must be submitted to the First Coast EDI gateway Smartxfr server via secure
file transfer protocol (SFTP) using a secure private network hosted by a participating network service vendor (NSV). The
valid X.509 digital certificates filename extensions allowed are:
• *.cer

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HTTPS CAQH CORE compliant connectivity guide 2/11/20, 10'20 PM

• *.crt
• *.der
• *.pem
If you receive a rejection on the transaction acknowledgment (TRNACK) report, please correct the issue and resubmit
your certificate. If you have submitted a successful X.509 digital certificate you will not receive a TRNACK report.
TRNACK reports rejections for incomplete or missing information
• Error number = 101 and severity = 1: Incomplete or missing certificate information – Serial Number
• Error number = 101 and severity = 1: Incomplete or missing certificate information – Issuer DN
• Error number = 101 and severity = 1: Incomplete or missing certificate information – Subject DN
• Error number = 101 and severity = 1: Incomplete or missing certificate information – Start Date
• Error number = 101 and severity = 1: Incomplete or missing certificate information – End Date
TRNACK report when a certificate has already been loaded to current organization
• Error number = 201 and severity = 1: Duplicate - Certificate already on file for this trading partner
TRNACK report when a certificate has already been assigned to a different organization
• Error number = 301 and severity = 1: Certificate linked to another trading partner
TRNACK report when a certificate is expired
• Error number = 401 and severity =1: Certificate authority not approved
TRNACK report when a certificate authority is not approved
• Error number = 401 and severity = 1: Certificate authority not approved – {message}
TRNACK report when a certificate is valid for more than 3 years
• Error number = 501 and severity = 1: Validity period greater than 3 years
TRNACK report when a certificate is invalid for an exception
• Error number = 602 and severity = 1: Certificate exception {message}
TRNACK report when a certificate is invalid, not properly formatted
• Error number = 602 and severity = 1: Fail to parse input stream
Once you have submitted a successful X.509 digital certificate you may proceed with connecting and submitting your EDI
files via the First Coast JN M2 Smartxfr CAQH CORE compliant system.
Connectivity URLs:
EDI Submitters connecting via SOAP will use the following link to connect, send, and receive their EDI transactions.
• https://coregateway.fcso.com/CoreBatchGateway/soap/coreservice
EDI Submitters connecting via MIME will use the following link to connect, send, and receive their EDI transactions.
• https://coregateway.fcso.com/CoreBatchGateway/TransactionSocketServlet
Supported transactions
The following EDI transactions are supported in batch mode.
1. Health Care Claim Status Request and Response (276/277)
2. Health Care Claim Payment Advice (835)
3. Implementation Acknowledgement for Health Care Insurance (999)

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Envelope data element definitions

CAQH CORE connectivity rule 270 defines the envelope requirements and envelope metadata. These are payer specific
requirements.

Element Value

Sender ID First Coast EDI assigned submitter ID

Received ID FCSO

Payload ID Unique identifier for a transaction submission. Must be unique for each transaction.

Payload Type Reference the different EDI transaction examples in the CAQH CORE Connectivity Rule
270

A Payload ID must be included in the request to download a “RECEIVE.999” or a “RECEIVE.TA1” file, to identify the
specific Ack to Retrieve. This ties the 999 and the TA1 back to the 276 they were generated from.
A Payload ID is not used to download a “RECEIVE.277_5010” or a “RECEIVE.835_5010”. When these files are
requested to download via CORE, the oldest format that has not yet been retrieved is downloaded.
Client software requirements
First Coast does not support the user’s client software. Visit http://www.caqh.org/sites/default/files/core/phase-ii/policy-
rules/270-v5010.pdf for information on the CAQH CORE 270 Connectivity rule. Trading partners will need to develop
the user’s client software that will communicate with the First Coast JN M2 Smartxfr CAQH CORE compliant system. The
trading partner will need client software that is compliant with the CORE standards outlined on the CAQH-CORE website.
First Coast cannot assist the user in developing this client software, nor does First Coast provide client software.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore,
this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or
forms that may become obsolete without notice.

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