HIPAA Transactions

The HIPAA transaction and code sets standards create a uniform way to perform electronic data interchange (EDI) transactions for submitting, processing, paying claims and other administrative healthcare transactions. The HIPAA standards covers these EDI health care transactions: Health claims or similar encounter information Health care payment and remittance advice Coordination of benefits Health claim status Enrollment and disenrollment in a health plan Eligibility for a health plan Health plan premium payments Referral certification and authorization