CAQH CORE is the organization overseeing the adoption of HIPAA transactions as part of the ACA mandated adoption of these transactions. During 2013, the eligibility transaction (270/271) and the claim status transaction (276/277) became mandated for use by all HIPAA eligible entities. At the beginning of 2014, rules pertaining to EFT and the 835 electronic remittance came into effect.
CAQH CORE has reported the adoption rates for electronic transactions as of the end of 2013. These numbers represent the percentage of these transactions that are conducted electronically of the total of all transactions of these transaction types.
|Claim Status Inquiry||72%|
These figures were calculated based on data provided by health plans covering about 40% of the covered lives in the U.S. For more information on this data and the compliance process, visit the CAQH CORE web site, www.caqh.org .
By Kalon Mitchell – President, MEDTranDirect