HIPAA EDI

HIPAA EDI Legislative Basics And Requirements HIPAA EDI is the process of using nationally established standards to exchange electronic information between business entities in health care. EDI national standards are developed and maintained by a group of standards development organizations (SDOs), such as the Accredited Standards Committee (ASC) X12 and the National Council of Prescription Drug Read More →

Medicare EDI Acronyms and Definitions Medicare EDI terms given below are represented by acronyms and definitions as assistance to understand the Medicare EDI terminology used in health care and insurance. EDI – Electronic Data Interchange – the process of using nationally established standards to exchange electronic information between business entities. HIPAA – Health Insurance Portability and Read More →

EDI For Medicare

EDI For Medicare Fee For Services (FFS) Introduction And Requirements EDI For Medicare FFS is not limited to the submission and processing of claim related transactions, but includes processes such as provider EDI enrollment, beneficiary eligibility, coordination of benefits, as well as security and privacy concerns. So as not to be duplicative, where EDI is a relevant part Read More →

Coordination of Benefits

Coordination of Benefits HIPAA Basics Coordination of Benefits requirements and basic procedure descriptions subject to the rules of the X12 837 HIPAA Technical Reports Type 3 (TR3s) as the national standard for provider electronic submission of health care claims to payers such as Medicare. It also contains the requirements for electronic transfer of claims from Medicare to Read More →