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  2. 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 ...

  3. ANSI 834 Enrollment Implementation Format - Wikipedia

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

    The entire string is called a transaction set. The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer. The format attempts to meet the health care industry's specific need for the initial enrollment and subsequent maintenance of individuals who are enrolled in insurance ...

  4. Healthcare Common Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Common...

    The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instructed CMS to adopt a standard coding systems for reporting medical transactions. The use of Level III codes was discontinued on December 31, 2003, in order to adhere to consistent coding standards.

  5. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    This process uses the same standards and technologies as an electronic claims transmission with small changes to the transmission format, this format is known specifically as X12-270 Health Care Eligibility & Benefit Inquiry transaction. [17]

  6. Protected health information - Wikipedia

    en.wikipedia.org/wiki/Protected_health_information

    Names; All geographical identifiers smaller than a state, except for the initial three digits of a zip code if, according to the current publicly available data from the U.S. Bureau of the Census: the geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; the initial three digits of a zip code for all such geographic units ...

  7. 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.

  8. Health Level 7 - Wikipedia

    en.wikipedia.org/wiki/Health_Level_7

    Health Level Seven, abbreviated to HL7, is a range of global standards for the transfer of clinical and administrative health data between applications with the aim to improve patient outcomes and health system performance. The HL7 standards focus on the application layer, which is "layer 7" in the Open Systems Interconnection model.

  9. Electronic data interchange - Wikipedia

    en.wikipedia.org/wiki/Electronic_data_interchange

    The VDA standard used within the European automotive industry, mainly in Germany. HL7, a semantic interoperability standard used for healthcare data. HIPAA, The Health Insurance Portability and Accountability ACT (HIPAA), requires millions of healthcare entities who electronically transmit data to use EDI in a standard HIPAA format.

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