Chapter Review

As you have seen, there are numerous steps and potential roadblocks on the path to payment for physician practices. The federal government has done its part by crafting a broad set of administrative simplification standards aimed at streamlining the claims revenue cycle. HIPAA, enacted in 1996, was the first of these efforts, leading to a wide array of privacy and security provisions designed to safeguard a patient’s health information, national identification numbers, and the standardization of a number of critical electronic transactions such as the claim, eligibility verification, and remittance advice. A voluntary industry effort started in 2006 to enhance the usefulness of electronic transactions led to the development of ...

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