AMA resource: Electronic transaction responsibilities, enforcement
The health care industry increasingly has moved from paper and telephone communications toward electronic interactions for information exchange. Designed to eliminate idiosyncratic electronic communication methods by health insurers and reduce administrative burdens and financial waste in the industry, standard electronic transactions for exchanging information between physicians and health insurers were mandated under the Health Insurance Portability and Accountability Act (HIPAA).
Physicians can truly realize the intended efficiencies and savings of the HIPAA standard transactions only if health insurers become and remain compliant with the regulations. Because the enforcement process is based on complaints, physician practices need to understand health insurers’ responsibilities and the enforcement avenues created by the regulations.
Click here (log-in required) to access an AMA resource that will help physicians understand and maximize the effectiveness of the standard transactions. This resource details the physician rights and health insurer responsibilities created by the HIPAA standard electronic transactions. It also advises physicians on how to respond when health insurers aren’t properly adhering to the regulations. Additionally, the AMA offers an archived webinar discussing the specific rights created under the HIPAA regulation.
Click here to visit the AMA’s electronic transaction compliance and enforcement webpage to access these resources and related information.
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