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This proposed rule is no longer the most current information.
It will continue to be available for reference, but the final rule
has been published. View the final
rule.
Proposed Standards for Electronic Transactions
and Code Sets
The Final Rule for Transactions was published
on August 17, 2000
This proposed rule is no longer the most current
information. It will continue to be available for reference, but
the final rule has been published. View
the final rule.
DHHS SUMMARY: This rule proposes standards for eight electronic
transactions and for code sets to be used in those transactions.
It also proposes requirements concerning the use of these standards
by health plans, health care clearinghouses, and health care providers.
The use of these standard transactions and code sets would improve
the Medicare and Medicaid programs and other Federal health programs
and private health programs, and the effectiveness and efficiency
of the health care industry in general, by simplifying the administration
of the system and enabling the efficient electronic transmission
of certain health information. It would implement some of the requirements
of Administrative Simplification subtitle of the Health Insurance
Portability and Accountability Act of 1996.
Implementation Guides:
EHNAC's Standard Transaction Format Compliance System (STFCS) has
been created as a response to HIPAA, which requires healthcare organizations
to send electronic administrative information via electronic data
interchange (EDI) in a single standard.
To meet the requirements of the law, the American National Standards
Institute’s ASC X12N (Insurance) subcommittee has published implementation
guides for the healthcare transactions covered by the law, to help
insure uniform implementation. Under HIPAA, all healthcare organizations
who use HIPAA-defined administrative transactions such as electronic
claims and claim payments, must use the ANSI ASC X12N standard implementation
guides.
The ANSI ASC X12N Implementation Guides expected to be named in
the Final HIPAA Transaction Standard Rule were initially published
in May 1999 and annotated in November, 1999, with some scheduled
for additional annotation in March, 2000.
ASC X12N HIPAA Transaction Standard Implementation Guides are available
via free download or other media at a nominal charge, through the
Washington Publishing Company
web site at www.wpc-edi.com.
The site also provides other useful information in support of the
Guides.
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