HIPAA Administrative Simplification

Administrative Simplification is defined in the Title II of the Health Insurance Portability and Accountability Act of 1996. Click here to view HIPAA Components. The goal of administrative simplification is to reduce health care administrative costs and promote quality and continuity of care by facilitating electronic data interchange (EDI). HIPAA establishes standards for 10 electronic health care transactions, national code sets, and unique identifiers for providers, health plans, employers and individuals. It also establishes standards for ensuring the security of electronic health care transactions.

Components of Administrative Simplification and the Implementation Date

  • Transaction Standards: The manner in which claim data will be sent from provider to payer. This component has been defined and compliance has been mandated for 10/16/2003.
  • Standard Code Sets: The information used to define the services rendered. This component has been defined and compliance has been mandated for 10/16/2003.
  • Unique Health Identifiers: The NPRM for the National Provider Identifier is currently in development. The National Individual Identifier has been placed on hold due to citizen concerns. The National Health Plan Identifier for Health Plans is currently in development.
  • Security Standards: Security Standards applies to your computer systems and how you store and send medical data. This component is being defined.
  • Electronic Signature Standards: This component is being defined.
  • Privacy: Privacy looks at the security of the individual's medical information within the provider's office. This component has been defined and compliance has been mandated for 4/14/2003.