The National Uniform Claim Committee was organized in May 1995 to develop, promote, and maintain a standard data set for use by the non-institutional health care community to transmit claim and encounter information to and from all third-party payers. The data set includes data elements, definitions, and code sets. Providers and suppliers may submit the NUCC data set using either a paper or electronic envelope.
The NUCC has received a formal consultative role regarding standards for health care transactions selected by the Secretary of Health and Human Services (HHS) as specified in the administrative simplification section of the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191). As specified in Act, American National Standards Institute (ANSI) accredited organizations must consult with the NUCC, the National Uniform Billing Committee (NUBC), the Workgroup for Electronic Data Interchange (EDI), and the American Dental Association (ADA). If the Secretary selects a standard different from one developed by an ANSI-accredited organization, she also must consult with the NUCC, NUBC, WEDI, and ADA.
The NUCC is chaired by the American Medical Association (AMA) with the Health Care Financing Administration (HCFA) as a critical partner. The Committee includes representation from key provider and payer organizations, as well as standards setting organizations, state and federal regulators, and the NUBC. As such, the NUCC is intended to have an authoritative voice regarding national standard data content and data definitions for non-institutional health care claims and encounters. The following organizations serve on the Committee as voting members:
- American Medical Association
- Health Care Financing Administration
- Alliance for Managed Care
- American Association of Health Plans
- ANSI ASC X12 Insurance Subcommittee
- Blue Cross and Blue Shield Association
- Health Insurance Association of America
- Medical Group Management Association
- National Association for Medical Equipment Services
- National Association of Insurance Commissioners
- National Association of State Medicaid Directors
- National Uniform Billing Committee
The NUCC will finalize its recommended data set in the first quarter of 1997 and make it available to the public. The NUCC also will provide formal comments into the ANSI ASC X12 Professional Implementation Guide for the Claim (837). Subsequently, the NUCC will address all other transactions specified in P.L 104-191.
The NUCC is not ANSI accredited; however, ANSI ASC X12 Insurance Subcommittee is a voting member of the NUCC, and several NUCC members are active in X12 and the HISB and are members of ANSI.