HIPAA Transactions in Dentistry
There are nine essential transactions included in the HIPAA regulations to support the administrative functions in healthcare. These along with their code numbers are shown in Table 1.
Table 1. HIPAA transactions and their code numbers.
|
|
|||||||||||||||||||||||||
The claims, claims payments, and claims status of HIPAA transactions are those key to dentistry, but other Data Interchange Standards Association (DISA) message formats will be useful in the other resource management functions shown in Figure 1 as time passes. (See: http://www.wpc-edi.com/hipaa)
|
Figure 1. Resource Management Function Taxonomy |
The Claims Attachments transaction lists EOHR information that may be needed for administrative functions from the resource management perspective. This may be either structured or free text data about a patient care event for which payment is being requested. Inserted into a single transaction container for transmission from the practice to a payer, it is the last transaction to be officially approved in the HIPAA transaction regulation. A detailed look at the 837 Dental Claim Transaction, as specified by the ADA, serves as a prime example of how all of these transactions are constructed.
 |
 |
| Page 4 of 13 | |
| Citation Number: Vol. 4, No. 4, Page 111 |
|
