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  2. Health Insurance Portability and Accountability Act - Wikipedia

    en.wikipedia.org/wiki/Health_Insurance...

    The EDI Health Care Claim Transaction Set (837) is used to submit health care claim billing information, encounter information, or both, except for retail pharmacy claims (see EDI Retail Pharmacy Claim Transaction). It can be sent from providers of health care services to payers, either directly or via intermediary billers and claims ...

  3. ANSI 834 Enrollment Implementation Format - Wikipedia

    en.wikipedia.org/wiki/ANSI_834_Enrollment...

    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.

  4. Workgroup for Electronic Data Interchange - Wikipedia

    en.wikipedia.org/wiki/Workgroup_for_Electronic...

    In July 1992, WEDI published a report that outlined the steps necessary to make electronic data interchange (EDI) a routine business practice for the health care industry by 1996. The Workgroup envisioned the entire health care industry transacting business electronically, under a nationwide set of coding and format standards for all transactions.

  5. ASC X12 - Wikipedia

    en.wikipedia.org/wiki/ASC_X12

    The Accredited Standards Committee X12 (also known as ASC X12) is a standards organization.Chartered by the American National Standards Institute (ANSI) in 1979, [2] it develops and maintains the X12 Electronic data interchange (EDI) and Context Inspired Component Architecture (CICA) standards along with XML schemas which drive business processes globally.

  6. What is HIPAA? What the health privacy law does and ... - AOL

    www.aol.com/finance/hipaa-health-privacy-law...

    This is called “rights of access” and requires HIPAA-covered entities to provide individuals with their medical records, billing records, enrollment, payment, claims adjudication, and other ...

  7. Electronic remittance advice - Wikipedia

    en.wikipedia.org/wiki/Electronic_Remittance_Advice

    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 ...