Regulations Require Unique Health Plan Identification Number

Posted by BAS - 10 May, 2012

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Health care reform requires the Department of Health and Human Services (HHS) to issue a series of regulations to streamline health care administration and make existing electronic health care transactions work more efficiently. This health care reform requirement is based on Congress recognizing that there is a need for a consistent framework for electronic health care transactions. The Health Insurance Portability and Accountability Act (HIPAA) was the initial attempt at streamlining health care transactions. The Affordable Care Act expanded on several of HIPAA's administrative simplification requirements.

HHS issued a proposed rule under health care reform that, if finalized, would require health plans to maintain a unique health plan identifier number (HPID). The HPID is intended to reduce plan administrative issues by making it easier to identify the parties involved in electronic health plan transactions.

HHS determined that presently, health plans are identified in standard transactions using multiple identifiers that differ in length and format. Health care providers often are frustrated by problems associated with the lack of a standard identification system. Multiple coding leads to rejected transactions based on insurance identification errors and difficulty determining patient eligibility. Health plan providers expect to experience increased efficiencies through the use of standard plan identification numbers.

BAS already works with plans and providers and is equipped to conduct electronic transactions using the required HIPAA formats. This new health plan identifier will further increase electronic transaction efficiencies, and BAS will be prepared to recognize and assist with the HPID implementation.

Topics: Health Care Reform (ACA)


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