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2. ANSI 834 Enrollment Implementation Format - Wikipedia

   en.wikipedia.org/wiki/ANSI_834_Enrollment...

   The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers.

3. Health Insurance Portability and Accountability Act - Wikipedia

   en.wikipedia.org/wiki/Health_Insurance...

   Health Insurance Portability and Accountability Act of 1996; Other short titles: Kassebaum–Kennedy Act, Kennedy–Kassebaum Act: Long title: An Act To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use ...

4. Protected health information - Wikipedia

   en.wikipedia.org/wiki/Protected_health_information

   There are many forms of PHI, with the most common being physical storage in the form of paper-based personal health records (PHR). Other types of PHI include electronic health records, wearable technology, and mobile applications. In recent years, there has been a growing number of concerns regarding the safety and privacy of PHI.

5. National Provider Identifier - Wikipedia

   en.wikipedia.org/wiki/National_Provider_Identifier

   The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.

6. Medical privacy - Wikipedia

   en.wikipedia.org/wiki/Medical_privacy

   HIPAA provides a federal minimum standard for medical privacy, sets standards for uses and disclosures of protected health information (PHI), and provides civil and criminal penalties for violations. Prior to HIPAA, only certain groups of people were protected under medical laws such as individuals with HIV or those who received Medicare aid. [41]

7. Medical billing - Wikipedia

   en.wikipedia.org/wiki/Medical_billing

   A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [2] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4]