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  2. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical ...

  3. Electronic Healthcare Network Accreditation Commission

    en.wikipedia.org/wiki/Electronic_Healthcare...

    EHNAC grew out of the 1993 Workgroup for Electronic Data Interchange (WEDI) meeting, sponsored by the Network Architecture and Accreditation Technical Advisory Group. The healthcare transactions industry agreed there was a need for a self-governing body to develop standards for the industry, and the Association for Electronic Health Care Transactions (AFEHCT) championed the cause by sponsoring ...

  4. Health Insurance Portability and Accountability Act - Wikipedia

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

    Under HIPAA, HIPAA-covered health plans are now required to use standardized HIPAA electronic transactions. See, 42 USC § 1320d-2 and 45 CFR Part 162. Information about this can be found in the final rule for HIPAA electronic transaction standards (74 Fed. Reg. 3296, published in the Federal Register on January 16, 2009), and on the CMS website.

  5. What is HETS in Medicare? - AOL

    www.aol.com/lifestyle/hets-medicare-013800100.html

    HIPAA Eligibility Transaction System (HETS) is an online tool for healthcare professionals to confirm Medicare eligibility and access information about coverage, deductibles, and other important ...

  6. ABC Codes - Wikipedia

    en.wikipedia.org/wiki/ABC_Codes

    ABC Codes are five-digit alpha codes (e.g., AAAAA) used by licensed and non-licensed healthcare practitioners to supplement medical codes (e.g. CPT and HCPCS II) on standard electronic (e.g. American National Standards Institute, Accredited Standards Committee X12 N 837P healthcare claims and on standard paper claims (e.g., CMS 1500 Form) to describe services, remedies and/or supply items ...

  7. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    Details are contained in a CMS document entitled, "Guidance on Compliance with the HIPAA National Provider Identifier (NPI) Rule." Small health plans have one additional year to comply. All individual HIPAA–covered healthcare providers or organizations must obtain an NPI for use in all HIPAA standard transactions, even if a billing agency ...

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