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The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers.
By regulation, the HHS extended the HIPAA privacy rule to independent contractors of covered entities who fit within the definition of "business associates". [23] PHI is any information that is held by a covered entity regarding health status, provision of health care, or health care payment that can be linked to any individual. [ 20 ]
strengthen the understanding of and commitment to EDI among the health care industry, policymakers, and consumers by: developing a targeted plan for using industry resources to educate key audiences on EDI, encouraging participation in demonstration projects that prove EDI benefits and cost savings, and expanding membership to reflect more ...
An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of a medical insurance payment explanation. It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations. The explanations include the denial codes and the descriptions, which present at the ...
The Health Insurance Portability and Accountability Act — otherwise known as HIPAA — has become a major topic of discussion amid the rollout of COVID-19 vaccines.
The EDI standard prescribes mandatory and optional information for a particular document and gives the rules for the structure of the document. The standards are like building codes. Just as two kitchens can be built "to code" but look completely different, two EDI documents can follow the same standard and contain different sets of information ...