Falls Church, Va., and Ann Arbor, Mich., September 23, 2005 - The Accredited Standards Committee (ASC) X12 and Health Level Seven (HL7) announced today that the Department of Health and Human Services (HHS) published a Notice of Proposed Rule Making (NPRM) for electronic claims attachments in the Federal Register. The publication of this NPRM-in accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996-is a landmark event for ASC X12 and HL7, whose members have worked collaboratively on these complex standards for electronic claims attachments since 1997.
"X12 and HL7 have worked together diligently to assess needs, develop harmonized standards and solicit industry feedback as it relates to the business of claims attachments," said Maria Ward, HL7's liaison to X12 and co-chair of HL7's Attachments Special Interest Group. "There was no external guidance persuading us to follow this path; we simply agreed that it was the best approach and worked in lock-step to develop what we know is an outstanding solution to the incredibly paper intensive, manual process of claims attachments in healthcare."
"We at X12 are so pleased to provide the healthcare industry with unified standards for electronic claims attachments, which streamline the process of evaluating medical situations involving rehabilitation services, emergency department, clinical reports, laboratory results, ambulance and medications," said ASC X12 Insurance Subcommittee Chair Alexandra Goss. "We look forward to continuing this productive partnership in other key ongoing standards development initiatives."
The electronic claims attachment standards include:
- Two ASC X12 Insurance Implementation Guides in version 004050 - 1) Transaction Set 275 - Additional Information to Support a Claim or Encounter, and 2) Transaction Set 277 - Request For Additional Information.
- HL7 Specifications, based on its Clinical Document Architecture (CDA), Release 1. This includes an Implementation Guide for Claims Attachments as well as six Additional Information Specifications (AIS) and a listing of Modifier Codes.
Both the ASC X12 Insurance Implementation Guides and the HL7 specifications can be downloaded free of charge at www.wpc-edi.com.
Pilot testing has proven the validity of the X12/CDA approach. We anticipate that once covered entities realize this, they too will embrace the standards and consider using them for claims attachments and other business needs. An example of ongoing work in this area involves the collaboration between ASC X12, HL7, and The National Council for Prescription Drug Programs (NCPDP) involving attachments for retail pharmacy prior authorizations to meet another pressing regulatory requirement under the Medicare Modernization Act.
About Accredited Standards Committee X12
The Accredited Standards Committee X12, accredited by the American National Standards Institute and comprised of cross-industry representation, develops robust e-business exchange standards using its EDI syntax and Context Inspired Component Architecture (CICA). CICA is a syntax-neutral architecture that enables members to generate XML documents. X12 standards interact with a multitude of e-business technologies and serve as a premier tool for integrating electronic applications. With more than 2,500 individuals representing 360+ corporate members, ASC X12 facilitates the effective exchange of electronic information through standards-setting and active participation in emerging and technically relevant initiatives. Propelling global e-business, ASC X12 is an active contributor to the United Nations/Electronic Data Interchange for Administration, Commerce and Transport (UN/EDIFACT), an international standard relating to the exchange of good and services. To learn more about ASC X12, visit http://www.X12.org or call 703-970-4480.
About Health Level Seven
Founded in 1987, Health Level Seven, Inc. (http://www.HL7.org/) is a not-for-profit, ANSI-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. HL7's more than 2,000 members represent approximately 500 corporate members, including 90 percent of the largest information systems vendors serving healthcare.
International affiliates have also been established in 25 countries throughout the globe including Argentina, Australia, Brazil, Canada, China, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, India, Ireland, Italy, Japan, Korea, Mexico, The Netherlands, New Zealand, Spain, Switzerland, Taiwan, Turkey and the United Kingdom. Recently, the HL7 Board approved the establishment of two new affiliates in Malaysia and Uruguay. To learn more about HL7, contact Jonathan Himlin at 734-677-7777 or firstname.lastname@example.org.