The HIPAA transactions and code set rules are intended to simplify things for healthcare and
health insurance providers. These rules are intended to standardize the electronic exchange
of health information about their customers.
The transactions and code set rules, which are based on the Electronic Data Interchange (EDI) standards, allow for information exchange from one computer to the other without the need for human intervention.
HIPAA requires that the medical data code set be standardised, removing all local and proprietary codes. Compliance with code set standards is simple because many of the adopted code sets are already in widespread use.
Furthermore, even after submitting claims, all practises are expected to be impacted by HIPAA transactions and code set standards, as payers, health plans, and insurance plans convert to using the standards in order to comply with HIPAA.
Implementing transactions and code set rules involves large scale business process reengineering that requires complex and costly undertakings. However, transactions and code set rules are the only parts of the HIPAA regulations that promise less overhead and more savings in office expenses.
At the same time, the standards allow for a fast improvement in the quality of services provided to the consumer. All you need to do to ensure that the standards are followed is to control the data output from your practise management system and send claims electronically in the standard formats.
Hence, we can say that where most of the HIPAA rules formulated by the HHS are meant for safeguarding the interests of the consumers in the healthcare and health insurance industry, the HHS transactions and code set rules are meant to make things easier for the health care and health insurance provider.
The best part is that with these rules even the interests of the customer are protected because avoiding human intervention in the transfer of sensitive data from one computer system to another ensures that human mistakes are made while doing so. Hence, we have adapted to the HHS transactions and code sets rules in order to make things faster at our end and ensure protected data transfer for our consumers.