Transactions are electronic exchanges involving the transfer of information between two parties for specific purposes. For example, a health care provider will send a claim to a health plan to request payment for medical services. In the HIPAA regulations, the Secretary of Health and Human Services (HHS) adopted certain standard transactions for Electronic Data Interchange (EDI) of health care data. These transactions are:
Under HIPAA, if a covered entity conducts one of the adopted transactions electronically, they must use the adopted standard.
Thank you for your replies. And, I will admit, I find myself now a little concerned about going to a cash-only clinic. The more you know.