HIPAA Transactions
HIPAA transactions are defined to streamline the process of a practice and its communications with the payers.
These HIPAA transactions are a set of EDI standards defined to support transactions like verification or elligibility of patient health plans, process pre authorizations, claim submissions, claim remittance.
These transactions are organized in a sequence of activities that need to be undertaken right from the moment the patient requests an appointment to the patient checking-in through check-out.
The HIPAA transactions and the standards to be followed is listed in the following chart in same sequence as discussed above
Transaction Type | EDI Standard for Transaction |
| Eligibility Verification Request from Practice | EDI-270 |
| Eligibility Response from Payer | EDI-271 |
| Authorization Request | EDI-278 |
| Authorization Response | EDI-278 |
| Claim Submission | EDI-837 |
| Claim Remittance | EDI-835 |
For more information on either implementing these transaction or buying these components refer to HIPPA Transactions.