Aug 20, 2024
New HIPAA Administrative Simplification Fundamentals Fact Sheet
From CMS - August 2024
Most Group Health Plans are Covered Entities. Whether the health plan is fully-insured, self-funded or level funded, the employer/plan sponsor is usually considered a 'covered entity'. Therefore, HIPAA Administrative Simplification Rules apply.
The Centers for Medicare & Medicaid Services’ (CMS) National Standards Group (NSG), on behalf of the Department of Health and Human Services (HHS), would like to highlight its new HIPAA Administrative Simplification Fundamentals Fact Sheet (PDF), located on the HIPAA and Administrative Simplification webpage of the Administrative Simplification website.
The new resource provides an overview of Administrative Simplification, its purpose, goals, and how the health care industry benefits from it.
Administrative Simplification requirements, which were authorized by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and subsequent legislation, govern how providers, health plans, and clearinghouses—otherwise known as HIPAA covered entities—handle electronic administrative transactions and set standards for transmitting health information.
When electronic administrative tasks between players in the health care industry are conducted the same way across all covered entities, the industry can automate many of its billing and payment processes, which reduces time spent on administrative tasks and saves health care dollars.
While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it. This publication is distributed on the understanding that the publisher is not engaged in rendering legal, accounting, or other professional advice or services. Readers should always seek professional advice before entering into any commitments.
