Become a Core Stakeholder

As a trusted and experienced CORE certification partner, we fully understand the concerns and challenges of testing. The process can be confusing and roadblocks with internal systems are common. That’s why we offer solutions and services for overcoming challenges with internal systems, setting up connectivity, creating master test data, understanding rules or policies, and mitigating resource constraints for testing.

What is a CORE Stakeholder?

By becoming a CORE Stakeholder, you’re providing assurance that your systems are conforming with the CAQH CORE operating rules and their underlying standards. This better enables the efficient and secure exchange of healthcare administrative data.

Who Should Become a CORE Stakeholder?

Providers (HIPPA 270/276 Transactions)
Physicians, physician groups, clinic systems, and hospitals who need to determine the eligibility or request claim status information on a patient.
Vendors (HIPPA 270/276 Transactions)
Organizations that provide practice management, eligibility-specific, or claim status-specific information systems to providers, hospitals, or other patient-care professionals.
Health Plans (HIPPA 271/277 Transactions)
Organizations who have members serviced by the provider community or need to respond to eligibility requests.
Clearinghouses can have many roles in the eligibility process and are given three options: submit request only, receive request only, and submit and receive requests.

How Do I Become a CORE Stakeholder?

The CORE certification process has four steps. Each step has action items that must be completed before moving to the next step. This enables our tester to execute compliance goals in a phased manner. Edifecs technical and business subject matter experts are available to help companies through the certification process.

Document with arrow

Pre-Certification Process

Pencil drawing line

Sign and Submit CORE Pledge

Box with magnifying glass on it

Certification Testing

Award icon

Apply for CORE Seal

Learn More


Certification Assessment
Assess your readiness for CAQH CORE Phase II, III and IV compliance across people, process & technology.
Certification Assistance
Expedite the certification testing process with our dedicated functional and technical subject matter experts.
Extended Testing
Take advantage of various test scenarios and load conditions in its Testing Service offering with configurable and scalable HIPAA and CORE validation.
Edifecs Ongoing Monitoring
Ensure ongoing compliance is maintained with continual surveillance and documentation of the certification testing process.
Edifecs Operating Rules Foundation Module
Meet specific testing requirements with built-in product configuration for successful implementation.


Test & Certify with Edifecs Certification Testing Portal
This free service enables health plans, providers, vendors, and clearinghouses to successfully complete all test cases recommended by CAQH CORE. We’ve helped over 190 organizations obtain CORE certification, expedite the certification process, and maintain on-going compliance with our industry leading services. CORE Phase I, II, III, & IV Testing System
Achieve & Maintain CORE Compliance with Edifecs Compliance Solutions and Services
Edifecs provides a full range of services and software solutions for customers to achieve and maintain CORE Compliance, including identifying gaps and building a remediation roadmap to bridge them. Edifecs also offers subject matter expertise and services to expedite the certification process.