The Department of Health and Human Services (HHS) announced a long-awaited proposed rule for new data standards for health care attachments and electronic signatures.
HIPAA and the Affordable Care Act (ACA) required HHS to develop and implement an electronic claims attachment standard. After many attempts, HHS has developed a proposed rule based on industry stakeholder input, with the goal of achieving industry consensus on this standard.
A summary of the proposed rule’s major provisions states “specifically this proposed rule would adopt standards for ‘health care attachments’ transactions, which would support health care claims and prior authorization transactions, and a standard for electronic signatures to be used in conjunction with health care attachments transactions. This rule also proposes modifying the referral certification and authorization transaction standard to move from the X12 278, Version 5010, to the X12 278, Version 6020.”
Health plans frequently require attachments as supporting documentation before paying claims or approving prior authorization requests. Without a standard, providers must utilize different – and often manual – processes for each health plan to provide these documents.
Citing research by the Council for Affordable Quality Healthcare (CAQH), HHS says the new standards would save the health care industry a total of $828 million per year. A standardized process would potentially save hundreds of hours of staff time for a typical practice.
We’ll follow this proposed rule and keep you advised of its progress.
The Advocacy Council – ADVOCACTING FOR ALLERGISTS AND THEIR PATIENTS.
