Healthcare Information Technology Exam Guide for CompTIA Healthcare IT Technician and HIT Pro Certifications

Foundational Standards Impacting the Claims Revenue Cycle

The movement toward automating the claims revenue cycle dates back to the inclusion of Subtitle F of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. HIPAA named certain types of organizations as covered entities, including health plans, healthcare clearinghouses, and certain healthcare providers, and required them to adopt a wide range of administrative simplification standards as well as new privacy and security requirements. Of particular relevance to the claims revenue cycle, HIPAA required the issuance of regulations to create standard transactions for electronic data interchange of healthcare data. The transactions named in HIPAA that impact physician practices ...