Health Insurance Portability & Accountability Act (HIPAA)
The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) required the Department of Health and Human Services (HHS) to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addressed the security and privacy of health data. As the industry adopts these standards for the efficiency and effectiveness of the nation's health care system will improve the use of electronic data interchange.
For more information, please check the Center for Medicare and Medicaid Services (CMS) website at http://www.cms.hhs.gov/HIPAAGenInfo/
HIPAA Updates
- HIPAA -2 Update, January 1, 2012 is the compliance date for the 5010 transactions. Will you be ready? How does this affect current HIPAA transactions? This final rule mandates adoption of newer versions of the original HIPAA standard transactions. The transactions being affected are:
837P, I and D - Professional, Institutional, and Dental
270-271 - Eligibility inquiry and response
276-277 - Health care claim status and response
835 – Health care payment and remittance advice
NCPDP D.O - POS Retail Pharmacy Drug and Professional services claims
What you should be doing – Contact your software vendor. If you currently use the Provider Electronic Solutions look for upgrades in the near future.
For additional information please visit the CMS website and RI Medicaid HIPAA 5010.
HIPAA Information
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