Prior to the Health Insurance Portability and Accountability Act of 1996, better
known as HIPAA, more than 400 different medical form standards were used in healthcare.
HIPAA was enacted in response to rising healthcare costs, to help introduce greater
efficiency. The law ultimately required the use of EDI for electronic transmission
of patient care and insurance information, replacing paper forms and increasing
standardization.
Today, the use of EDI in healthcare is the norm, ensuring the safe and efficient
exchange of critical, personal information. Still, it continues to raise a variety
of challenges for healthcare providers and insurance companies.
New EDI Standards, New Challenges for Healthcare
The initial EDI standards for transmission of healthcare claims and other healthcare-related
information took effect in 2003. Some of the key ANSI X12 standards utilized in
healthcare include:
Starting January 2012, version 5010 of the HIPAA X12 EDI transaction definitions
must be followed. At the same time, an update of the International Classification
of Diseases (ICD) standard is also taking place. A compliance date for the new list,
called ICD-10, has been set for October 2013. The ICD-10 list, which provides classification
of diseases to ensure common language throughout the industry, was originally developed
in 1977. The new list is much more detailed, with a longer code length to accommodate
that greater level of specificity in each disease definition.
Version 5010 of the X12 EDI standards under HIPAA allows for the larger field size
of ICD-10, as well as supporting additional improvements.
These new standards, with accompanying compliance mandates, are putting significant
pressure on everyone in the healthcare industry. Health industry IT professionals
must work with management to redesign processes and systems to handle hundreds of
new codes. While the changes will have longer-term benefits, implementing them will
be challenging in the near term for all involved.
Let 1EDISource Help
1EDISource can offer healthcare institutions
with highly effective EDI solutions that accommodate 5010 standards. Our
advanced EDI software includes a healthcare industry-specific solution to
accommodate the particular needs of hospitals, clinics and other healthcare providers.
EDI/HQ™ Healthcare
is a focused solution to accommodate the particular needs of hospitals, clinics
and other healthcare providers. In addition to the extensive functionality that
comes standard in EDI/HQ™, you get support for a variety of transactions and
different requirements specific to healthcare.
Alternatively, let the experts at 1EDISource
manage your entire EDI operation, with an EDI
Outsourcing solution. You get all of the EDI communications and integration,
security and support for HIPAA standards, without the need to install and maintain
the software, hardware and other resources.
Talk to one of our EDI Experts to learn how 1EDISource can help you implement an EDI
solution for the secure and reliable exchange of healthcare information with full
HIPAA compliance.
All of the world-class EDI solutions from 1EDISource
come with our unparalleled service and support.
You get a dedicated EDI Consultant backed by a team of experts, ready to help you.