Health Partners Plans HIPAA Basics: Transactions, Code Sets And Identifiers (Continued)
Health Partners Plans HIPAA requirements subject to general rules set by HIPAA standards. Health Partners Plans HIPAA program is built on the basis of international health care demands. As we know, HIPAA originally was conceived to improve fraud and abuse protections and provide protections for workers insured under group health plans when they leave their jobs and join a different group health plan. Health Partners Plans HIPAA rules also ensure administrative simplification across the health care industry by reducing paperwork, and ensure the confidentiality and privacy of health information about Health Partners Plans HIPAA vendors and members. In the previous post we gave the first portion of general HIPAA regulations. Below find more current definitions of HIPAA regulations.
TRANSACTIONS, CODE SETS and IDENTIFIERS – enforced by Centers for Medicare & Medicaid Services (CMS)
Standard Unique Identifier for Employers This final rule was jointly developed by CMS, Treasury, Labor, and Defense. The regulation adopts an employer’s tax ID number or Employer Identification Number (EIN) as the standard for electronic transactions, implementing an administrative simplification initiative that has a national scope beyond the Medicare and Medicaid programs.
Standard Unique National Health Plan (Payer) Identifier: This proposed rule would implement a standard identifier to identify health plans that process and pay certain electronic health care transactions. It would implement one of the requirements for administrative simplification that have a national scope beyond Medicare and Medicaid.
Claims Attachments Standards: This rule proposes an electronic standard for claims attachments as required by HIPAA. It would be used to transmit clinical data, in addition to those data contained in the claims standard, to help establish medical necessity for coverage.
HIPAA Enforcement: This rulemaking would seek to establish a framework for enforcing compliance with the “administrative simplification” provisions of HIPAA.