Topic > Electronic Transmission Standard - 1117

Electronic Transaction Standard The protocols for sending and receiving "private" information over the Internet are continually evolving. In the healthcare sector, in particular, privacy is a key issue. The Health Insurance Portability and Accountability Act of 1996 (HIPPA), requires the Department of Health and Human Resources (HH S) to adopt standards that must be used when electronically conducting certain healthcare administrative transactions, such as insurance claims and responses (Centers for Medicaid and Medicare Services [CMS]). The current version 4010 lacks some features required by the healthcare industry and, just like other software programs, has become obsolete. Because transaction version 4010 is referenced in a federal rule, you must follow the regulatory process to upgrade to version 5010 (American Medical Association [AMA] 2011}. New standards have been prepared to allow for seamless submission of electronic transactions by providers HIPPA required the healthcare industry to use standard formats for electronic claims and claims transactions (CMS). The final rule was published on January 16, 2009 and makes version 5010 transactions mandatory from 1. ° January 2012 (AMA The). International Classification of Diseases, Tenth Revision (ICD-10) was developed and is managed by the World Health Organization (WHO) and is updated annually (CMS) to process transactions using new ICD-10 code set, software version 5010 The Final Rule was also issued, adopting ICD-10 as the new code set and is mandatory starting October 1, 2013 (AMA) for more than 99% of credit transactions Medicare Part A and 96% Medicare Part B claims are received electrons......center of paper......ReferencesAmerican Medical Association. Electronic Administrative Transactions Version 5010. Retrieved September 26, 2011, from http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hippahealth-insurance- portability -accounting-deed/transactionAmerican Medical Association. (9 September 2011). Preparing for the next version of HIPPA standards: Compliance date of January 1, 2012. Retrieved September 29, 2011, from http://www.ama-assn.org Centers for Medicaid and Medicare Services. New standards for electronic transactions in the healthcare sector. Retrieved September 26, 2011, from http://www.cms.gov/ICD10/Downloads/w5010BasicsFctSht.pdfJohnson, K., MAEd, CHIM & Weirz, C., MBA BSN, RN. (2011). HelloMSS11. Implementation of ICD-10. Retrieved October 7, 2011, from http://www.himss.org