HHS Issues Electronic Standards for Healthcare Transactions

The Department of Health and Human Services has implemented an Affordable Care Act provision that establishes electronic standards to improve efficiency and save an estimated $12 billion over the next ten years, according to an HHS news release.

The rule is estimated to save $12 billion through reduced transaction costs from phone calls between payors and providers, lower postage and paperwork costs, fewer denied claims and an increase in automation for healthcare administrative processes.

In addition to saving money, the standardized electronic transactions are designed to allow physicians to reallocate time spent on administrative duties to patient care. The standards should help providers more easily determine a patient's eligibility for coverage and the status of a healthcare claim submitted to a payor.

The interim final rule implements Section 1104 of the Affordable Care Act and bases its operating rules principally on the rules developed by the Council for Affordable and Quality Healthcare's Committee on Operating Rules for Information Exchange.

Health plans, healthcare clearinghouses and certain providers must comply by Jan. 1, 2013.

The standardization of electronic healthcare processes is the beginning of a series of improvements HHS plans to implement, including standards for electronic funds transfer and remittance advice, identifiers for health plans, claims attachments and compliance with HIPAA.

Read the HHS release on electronic standards.

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