HIPAA Electronic Transactions Standards
The Electronic Transaction & Code Set Standards include, among other things, the following:
- Health claims or equivalent encounter information (Transaction Type 837).
- Health care payment and remittance advice (Transaction Type 835).
- Eligibility for a health plan (Transaction Types 270 and 271).
ANSI, the American National Standards Institute, created the standard formats for all of these transactions. CompuMedic and elligence can both create claim files for Medicare in version 4010, as required by HIPAA.
Health plans are required to conduct electronic transactions with healthcare providers, on or before the compliance date required under HIPAA. The compliance date for the Electronic Transaction Standards provisions of HIPAA was October, 16, 2002, or one year thereafter if insurer requests extension from the federal goverment.
Always ready with the features you need well in advance of government requirements, DSI was one of the first healthcare software vendors in the country to adopt the ANSI standard for EMC submission (ANSI 837) as well as electronic remittance advice (ANSI 835). In addition, elligence also supports the electronic eligibility portion of this standard.