Statements (44)
| Predicate | Object |
|---|---|
| gptkbp:instanceOf |
gptkb:standard
|
| gptkbp:appliesTo |
healthcare providers
health plans covered entities healthcare clearinghouses |
| gptkbp:country |
gptkb:United_States
|
| gptkbp:enforcedBy |
gptkb:Centers_for_Medicare_&_Medicaid_Services
|
| gptkbp:exampleTransaction |
270/271 Eligibility Inquiry/Response
275 Patient Information 276/277 Claim Status Inquiry/Response 278 Referral Authorization 820 Premium Payment 824 Application Reporting 834 Benefit Enrollment and Maintenance 835 Health Care Payment/Remittance Advice 837 Health Care Claim |
| gptkbp:firstMandated |
2003
|
| gptkbp:fullName |
Health Insurance Portability and Accountability Act Electronic Data Interchange
|
| https://www.w3.org/2000/01/rdf-schema#label |
HIPAA EDI
|
| gptkbp:mandate |
gptkb:HIPAA
|
| gptkbp:purpose |
reduce administrative costs
ensure data accuracy improve efficiency of healthcare data exchange protect patient information |
| gptkbp:regulates |
electronic transmission of healthcare data
|
| gptkbp:relatedTo |
gptkb:HIPAA_Privacy_Rule
gptkb:HIPAA_Security_Rule gptkb:HL7 gptkb:NCPDP gptkb:ASC_X12 |
| gptkbp:requires |
compliance with security and privacy rules
use of standard code sets use of standard transaction formats |
| gptkbp:standardizedBy |
ASC X12N
|
| gptkbp:usedFor |
coordination of benefits
eligibility inquiries enrollment and disenrollment payment and remittance advice premium payment referral authorization claim status requests healthcare claims |
| gptkbp:bfsParent |
gptkb:Electronic_Data_Interchange_(EDI)_standards
|
| gptkbp:bfsLayer |
7
|