As required by HIPAA, the Secretary of Health and Human Services is adopting standards for the following administrative and financial health care transactions:
- Health claims and equivalent encounter information.
- Enrollment and disenrollment in a health plan.
- Eligibility for a health plan.
- Health care payment and remittance advice.
- Health plan premium payments.
- Health claim status.
- Referral certification and authorization.
- Coordination of benefits.
Standards for the first report of injury and claims attachments (also required by HIPAA) will be adopted at a later date.