Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Financing Health Care - Part 2
Lecture:The Billing Process of Various Health Care Enterprises
Slide content:Electronic Claims Transactions American National Standards Institute Electronic Data Interchange (EDI) HIPAA privacy rules/Transactions Rule 837 Health care claims or equivalent encounter information 835 Health care payment and remittance advice 270/271 Eligibility for a health plan 276/277 Health claims status 278 Referral certification and authorization 7
Slide notes:The American National Standards Institute, or ANSI, oversees the development of standards for products, services, processes, systems, and personnel in the U.S. The Accredited Standards Committee X12, or ASC X12, chartered by ANSI, develops EDI standards. This slide lists some of the ASC X12-specific HIPAA EDI transaction sets used to transmit information and claims electronically for eligibility status, claim submission, claim status, claim remittance, and referral certification and authorization. 7