Electronic Data Interchange


EDI commonly refers to data formats used in the processing of medical claims. EDI standards, such as 5010, streamline the transfer of data between payers and providers. Look here for stories on emerging federal requirements, the role of claims clearinghouses, and transaction standards.


Fairly Shocking: The Feds as an Efficiency Leader?

Greg Gillespie | Feb 10
My father wasn’t the first or last to say that it will be a sad day indeed if the private sector ever gets lapped by the feds in terms of efficiency.
Coding
Group Practices

Survey Ranks ‘Fairness’ of Payer Reimbursements

Joseph Goedert | Feb 07
A survey from IVANS Inc., a transactions processing vendor, finds large numbers of its provider customers believe Medicare and Medicaid reimburse more fairly than commercial insurers, even though the government plans pay less.
Revenue Cycle Management
Policy & Regulation

HIPAA 6020 Put on Back Burner, for Now

Joseph Goedert | Feb 07
Health care stakeholders struggling to comply with the HIPAA 5010 transaction sets need not worry about one thing-- the next-generation 6020 transactions are not coming to a theater near you any time soon.
Coding
Revenue Cycle & Payments

AHIMA Readies its ICD-10 Summit

Joseph Goedert | Feb 07
The American Health Information Management Association will again hold its annual ICD-10 Summit, April 16-17 in Baltimore.
Coding
Document Management

Health Plan ID, Insurance Exchange Rules Coming Soon

Joseph Goedert | Feb 06
The Department of Health and Human Services expects soon to publish a final rule to govern establishment of state insurance exchanges to provide one-stop shopping for health coverage, and a proposed rule to establish the long-delayed unique identifier for health plans.
Policy & Regulation
Consumer Health

CMS Demo Programs Will Require Providers to Do More to Justify Claims

Joseph Goedert | Feb 03
The Centers for Medicare and Medicaid Services is getting ready to launch two new data collection programs, affecting providers and their revenue streams by making them further justify claims submitted for payment.
Revenue Cycle Management
Payers

MGMA Asks HHS for More Time, Fixes to HIPAA 5010

Joseph Goedert | Feb 02
The Medical Group Management Association has sent a letter to HHS Secretary Kathleen Sebelius outlining significant problems with federal reimbursement of claims following the transition to the HIPAA 5010 transaction sets.
Coding
Revenue Cycle Management

AMA to Sebelius: Stop ICD-10

Joseph Goedert | Feb 02
The American Medical Association, which is actively working to stop implementation of the ICD-10 code sets, has sent a letter to HHS Secretary Kathleen Sebelius asking her to immediately halt the implementation process.
Coding
Policy & Regulation

5010 – Ready or Not, Here It Comes (Part 3 of 3)

Jackie Griffin | Jan 31
There is absolutely no denying it now – HIPAA 5010 is here, and we’re all feeling the weight of it. Over the past few weeks, I’ve been presenting on 5010 with associations and talking with representatives from all different areas of the industry to get a feel for the main points of pains that are out there.
Coding
Policy & Regulation

AHIMA: AMA Stance on ICD-10 Should Not Slow Down Work

Joseph Goedert | Jan 30
With the American Medical Association ramping up its fight against the ICD-10 code sets by asking House Speaker John Boehner for assistance in stopping mandated implementation, the American Health Information Management Association is warning against slowing down compliance work.
Coding
EHR

AMA Asks Speaker Boehner to Kill ICD-10

Joseph Goedert | Jan 26
The American Medical Association is asking House Speaker John Boehner to help stop implementation of the ICD-10 code sets and call on the industry to assess an appropriate replacement for ICD-9, The Hill newspaper reports.
Comments (3)
Coding
EHR

Conference Call to Update CORE Rules for HIPAA Transactions

Joseph Goedert | Jan 19
A free Town Hall call on the CORE operating rules to tighten the HIPAA administrative and financial transactions, which are mandated under the Affordable Care Act, is scheduled on Jan. 24 at 3 pm Eastern Time.
Coding
Payers

Vendors on a Buying Spree

Joseph Goedert | Jan 12
Four more health information technology vendors have announced acquisitions, bringing the total during the first 12 days of 2012 to at least 10 deals.
Comments (1)
Payers
Hospitals

New Tools for Physicians on AMA Web Site

Joseph Goedert | Jan 12
The American Medical Association has enhanced its Practice Management Center Web site for members and nonmembers.
Coding
Revenue Cycle Management

ED Vendor T-System Buys Billing Firm

Joseph Goedert | Jan 11
Emergency department information systems vendor T-System Inc. has acquired outsourced billing firm Practice Management Associates for an undisclosed price.
Hospitals
Revenue Cycle Management
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