CMS Releases Administrative Simplification Factsheet

PUBLISHED: Apr 11, 2017
Source: Centers for Medicare and Medicaid Services
Relevant to: Behavioral Health, Medical Office/Clinic, Lab, Long Term Care, Hospital, Ambulatory Care, Hospice, Home Health

To reduce paperwork and streamline business processes across the health care system, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the Patient Protection and Affordable Care Act (ACA) set national standards for:

  • Electronic transactions
  • Code sets
  • Unique identifiers

HIPAA includes Administrative Simplification provisions that the ACA (Affordable Care Act) expanded in 2010. ACA introduced operating rules to standardize business practices. A new CMS fact sheet explains how Administrative Simplification standards streamline day-to-day tasks like:

  • Billing
  • Verifying patient eligibility
  • Sending and receiving payment

The standards apply to entities who exchange health care information electronically, including:

  • Health plans
  • Health care providers
  • Clearinghouses

Follow the link below at access the new fact sheet.

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