Health insurers will soon be required to certify their compliance with HIPAA electronic transaction rules, according to the U.S. Department of Health and Human Services (HHS).

HHS has proposed that health insurers, those providing HIPAA-covered health plans, and certain business associates certify they are following all the rules and standards for HIPAA transactions so they can remain eligible for certain health plans, health care claim status, health care electronic funds transfers, and remittance advice.

If you have questions about any of the following business practices, let the consultants at EIXSYS conduct a thorough and professional review:

  • Eligibility & Benefits Inquiry
  • Claims Status
  • Electronic Funds Transfer (EFT)
  • Healthcare Payment and Remittance Advice (ERA)
  • Health Claims or Equivalent Encounter Information
  • Health Plan Enrollment/Dis-enrollment
  • Health Plan Premium Payments
  • Referral, Certification, and Authorization
  • Health Claims Attachments