270, 271 Healthcare Eligibility, Coverage and Benefit Inquiry (270) and Response (271) EDI Transaction Definition 270, 271 Healthcare transactions, their relationship, functions and purposes will be described further in the post. The 270 transaction is the EDI function that requests eligibility and benefit information from the Insurance Company of the patient. It is set to receive Read More →

834 Healthcare EDI Transaction – Benefit Enrollment and Maintenance 834 Healthcare EDI Transaction (Benefit Enrollment and Maintenance) is used to provide enrollment information from sponsors to insurance companies. Sponsors are typically corporations or other institutions that provide health care benefits to their employees. The 834 Healthcare EDI can be used to provide initial enrollment and also Read More →

EDI Training Chicago – EDI Fundamentals and Best Practices and HIPAA EDI Advanced Course EDI Training Chicago is a good possibility to widen your EDI knowledge and become an EDI professional in the field of HIPAA and healthcare EDI. Today many EDI specialists are self-taught or just get information about electronic data interchange from vendor sources (guidelines). This Read More →

EDI Privacy Requirements impact on parties EDI privacy requirements should be analized regarding parties. The employer/plan sponsor is not a covered entity. Technically he does not have to directly comply with the Privacy Regulations. However, employers and plan sponsors will indirectly be impacted. The general health plan (GHP) or its insurer or business associate may not disclose Read More →

HIPAA EDI Privacy – part of the Anthem’s HIPAA regulations HIPAA EDI Privacy  addresses protecting the privacy of protected health information (PHI). As part of the HIPAA regulations, the government has established some controls. They will limit how, when and where protected health information is shared. Medical information, as well as emographic information, is “Protected Health Information” (PHI). Anthem Read More →

Health industry EDI non-medical related code sets as an integral part of electronic transactions Health industry EDI code sets include any set of codes used for encoding data elements. Examples: tables of terms, medical concepts, medical diagnosis, or medical procedure codes. They are used in Health industry EDI to describe various health care services, procedures, tests, Read More →

HIPAA Compliance – the right way to standardization in a health care industry HIPAA Compliance at Anthem started in January 2000. In that year Anthem created the HIPAA Program Office. It was done to oversee all of Anthem’s HIPAA compliance activities. Since then, multiple HIPAA rules have been passed, including rules related to standard transactions and Read More →

Anthem HIPAA  as a permanent component of Anthem’s health care strategy Anthem HIPAA  strategy is developed to deliver excellent service. The commitment includes compliance with and support of the HIPAA mandates. Anthem is committed to standardization and the minimization of “administrative hassles”. This is done for Anthem members, physicians and other health care professionals. Also Anthem HIPAA is Read More →

HIPAA EDI 837 Transaction Terminology HIPAA EDI 837 Transaction  is a key component in electronic health care documents transmission. This process improves efficiency in health care by establishing and constantly improving national standards for clearing houses, providers and health insurance plans. HIPAA EDI 837 Transaction  is one of the most used EDI transactions. If you somehow deal with EDI in health care Read More →