What is HIPAA? |
Helpful HIPAA Web Sites
What is HIPAA?
In 1996 Congress passed into law the Health Insurance Portability and
Accountability Act (HIPAA). This Act is comprised of two major legislative
actions:
- Health Insurance Reform, and
- Administrative Simplification
The Administrative Simplification provisions of HIPAA direct the federal
government to adopt national electronic standards for automated transfer
of certain health care data between health care payers, plans, and providers.
-
Medicare HIPAA ANSI X12N 837 version 4010A1 testing information: The Administrative Simplification provisions of HIPAA direct the federal government to adopt national electronic standards for the automated transfer of certain health care data between health care payers, plans, and providers. This enables the entire health care industry to communicate electronic data using a single set of standards, thus eliminating all nonstandard formats currently in use.
Although CMS has implemented a contingency plan that allows Medicare to continue accepting and processing claims in the standard and non-standard formats, version 4010A1 will be the HIPAA compliant format once CMS revokes the contingency. Each provider must submit all of their electronic claims, claim status inquiry, and eligibility inquiry in compliance with the requirements in the X12N 837 version 4010A1.
NHIC is ready to schedule testing and transition EDI submitters, clearinghouses and vendors to version 4010A1. Submitters with custom systems, clearinghouses and vendors whose software has already been tested and approved by NHIC for version 4010 will not be required to test again for version 4010A1.
Helpful HIPAA Web Sites
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05/01/2009
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