Transactions Overview
What Is a Transaction?
A transaction is an electronic exchange of information between two parties to carry out financial or administrative activities related to health care. For example, a health care provider will send a claim to a health plan to request payment for medical services.
Health Care Transactions Basics (PDF)
Overview document of electronic transactions used in health care to increase efficiencies in operations, improve the quality and accuracy of information, and reduce the overall costs to the system.
Standards for Transactions
Under HIPAA, HHS adopted certain standard transactions for the electronic exchange of health care data. These transactions include:
HIPAA covered entities who conduct any of these transactions electronically must use an adopted standard from ASC X12N or NCPDP (for certain pharmacy transactions).
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