An Approach to HIPAA 5010 conversion

In 1996, Congress passed HIPAA to establish national standards for health care transactions. The main focus is to address patient privacy rights, health insurance portability, and the administration simplification of health care payers. Health care electronic data interchange (EDI) transactions such as eligibility, claim status, referrals, claims, remittances, member enrollment and maintenance, and premium payments are all impacted by the regulation. This paper discusses HIPAA drivers, compliance schedule, changes, impacts on various stakeholders, benefits of adoption, and approaches to successful completion of this conversion.

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