275 X211 HIPAA

275 X211 – Patient Information: Definition and Usage The 275 X211 – Patient Information transaction is a standardized electronic document used for exchanging patient information between healthcare providers, payers, and other entities involved in the healthcare industry via EDI. This transaction set is part of the ANSI X12 EDI standards, which are widely used in Read More →

X12 HIPAA

X12 and X12 HIPAA: related but still distinct concepts X12 refers to a set of standards developed by the Accredited Standards Committee (ASC) X12, which is responsible for developing and maintaining electronic data interchange (EDI) standards in the United States. These standards govern the exchange of business documents, such as purchase orders, invoices, and shipping Read More →

Medical Codes

Health Care Code Sets Types In healthcare electronic data interchange (HIPAA EDI), code sets play a fundamental role in standardizing the representation of various healthcare concepts, such as diagnoses, procedures, medications, and other medical entities. These code sets are used to facilitate the exchange of healthcare information between different healthcare providers, payers, and systems.┬áHere are Read More →

HIPAA EDI

CAQH CORE Operating Rules for Eligibility and Claims Status Operating rules for eligibility and claims status went into effect on January 1, 2013. They make it easier for providers to determine: Whether a patient is eligible for coverage (transaction 270/271) The status of a health care claim submitted to a health insurer (transaction 276/277) Eligibility Read More →