EDI may crimp correct claims payment

Lee, Karen
April 2004
Employee Benefit News;4/15/2004, Vol. 18 Issue 5, p1
Focuses on concerns that federal rules for electronic data interchange (EDI) and medical code standards enacted under the auspices of the U.S. Health Insurance Portability and Accountability Act of 1996 may hinder efforts to track claims that cost self-funded employers. Problems in using EDI; Remarks from John Richards of Innovative Health Strategies, regarding the use of EDI; Mandate of the federal government for third-party administrators handling electronic claims. INSET: Nine steps to health plan savings.


Related Articles

  • Payers required to adopt standardized electronic claims... Moynihan, James J.; McLure, Marcia L. // hfm (Healthcare Financial Management);Jan98, Vol. 52 Issue 1, p62 

    Focuses on Health Insurance Portability and Accountability Act of 1996 which requires most claim payers to support electronic claims processing and uniform national standards for code sets and identifiers to streamline healthcare administration. Opportunities that many providers are facing with...

  • Compliance With EDI Rule. Williams III, Arthur W. // ASHA Leader;9/9/2003, Vol. 8 Issue 16, p13 

    Reports on the development of the electronic data interchange (EDI) rule as part of the Health Insurance Portability and Accountability Act in the U.S. Reduction in the administrative complexity associated with the electronic transfer of health care data; Ways to comply with the EDI rule;...

  • Collections grow with EDI. Hand, S. Mark // hfm (Healthcare Financial Management);Sep98, Vol. 52 Issue 9, p80 

    Reports on the passage of a law in Oregon that could dramatically improve insurance payment collections for healthcare organizations using electronic data interchange (EDI) technology for eligibility verification. Challenge of verifying and documenting verification of patient enrollment in...

  • HIPAA Hype. Clarke, Richard L. // hfm (Healthcare Financial Management);Nov2000, Vol. 54 Issue 11, p16 

    Presents information on the Health Insurance Portability and Accountability Act of 1996 passed by the United States Congress. Purpose of a uniform set of electronic data interchange standards; Details on security and privacy concerns involved in the act; Financial and organization issues in...

  • Self-insured plans on high alert for HIPAA EDI rules. Elswick, Jill // Employee Benefit News;Feb2001, Vol. 15 Issue 2, p41 

    Reports on the compliance for electronic data interchange (EDI) rules and medical code standards governing health plan information transactions. Consequences of the failure to comply with the rules; Transactions under the Health Insurance Probability and Accountability Act EDI rules; Why many...

  • WEDI Soon to Close Claims Attachments Survey. Goedert, Joseph // Healthdatamanagement.com;4/11/2012, p3 

    The article reports that the electronic claims attachments, and what stakeholders want, from the Workgroup for Electronic Data Interchange in the U.S. will close on April 13, 2012.

  • The Impact of Electronic Claims Submission on Cash Flow in a Private Practice. Williams III, Arthur W. // ASHA Leader;6/11/2002, Vol. 7 Issue 11, p12 

    Reports that speech-language pathology and audiology practices can improve their efficiency of operation and cash flow through electronic claims submission. Impact of the Health Insurance Portability and Accountability Act's rule on electronic claims submission; Factors to consider in adopting...

  • Imminent HIPAA compliance deadlines must be met. Painter, Ray // Urology Times;Sep2002, Vol. 30 Issue 9, p36 

    Discusses the issue of compliance concerning the upcoming Health Insurance Portability and Accountability Act (HIPAA) in the United States. Standardization of the Electronic Data Interchange; Standardization of the Privacy of Health Information; Deadlines for complying with standardization;...

  • Federal regs spur total electronic claims processing. Gillette, Bill // Managed Healthcare Executive;Apr2003, Vol. 13 Issue 4, p36 

    Describes a provision under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on electronic claims processing. Establishment of standards for electronic healthcare transactions and national identifiers for providers, health plans and employers; HIPAA-compliant software...


Read the Article


Sign out of this library

Other Topics