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Episode 162: Workgroup Voices, The Inner Workings of Prior Authorization

April 15, 2019

The federal agency responsible for regulations governing standardization of electronic transactions and data accessibility for consumers is ramping up adherence efforts.

HealthDataManagement LogoThe Department of Health and Human Services is launched a pilot auditing program, starting with health plans and claims clearinghouses, to ensure industry stakeholders are complying with HIPAA-related rules governing electronic healthcare transactions.

In April, the HHS selected nine covered entities for the pilot initiative for a compliance review. Transactions that will be assessed include electronic funds transfer, remittance advice, responses to eligibility for benefits requests and claim status requests.

To read the full article, visit Health Data Management.

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