HIPAA Compliance Guide

HIPAA Overview & Regulations

HIPAA Compliance Guide
What is HIPAA? What is a HIPAA BAA?
Regulations
General Administrative Requirements
Subpart A
General Provisions
Subpart B
Preemption Of State Law
Subpart C
Compliance and Investigations
Subpart D
Imposition of Civil Money Penalties
Subpart E
Procedures for Hearings
Administrative Requirements
Subpart A
General Provisions
Subpart D
Standard Unique Health Identifier For Health Care Providers
Subpart E
Standard Unique Health Identifier For Health Plans
Subpart F
Standard Unique Employer Identifier
Subpart I
General Provisions For Transactions
Subpart J
Code Sets
Subpart K
Health Care Claims Or Equivalent Encounter Information
Subpart L
Eligibility For A Health Plan
Subpart M
Referral Certification And Authorization
Subpart N
Health Care Claim Status
Subpart O
Enrollment And Disenrollment In A Health Plan
Subpart P
Health Care Electronic Funds Transfers (EFT) And Remittance Advice
Subpart Q
Health Plan Premium Payments
Subpart R
Coordination Of Benefits
Subpart S
Medicaid Pharmacy Subrogation
Security and Privacy
Subpart A
General Provisions
Subpart C
Security Standards For The Protection Of Electronic Protected Health Information
Subpart D
Notification In The Case Of Breach Of Unsecured Protected Health Information
Subpart E
Privacy Of Individually Identifiable Health Information

Administrative Requirements   >   Health Care Claim Status

§ 162.1403 Operating rules for health care claim status transaction

On and after January 1, 2013, the Secretary adopts the following:

(a) Except as specified in paragraph (b) of this section, the following CAQH CORE Phase II operating rules (updated for Version 5010) for the health care claim status transaction:

(1) Phase II CORE 250: Claim Status Rule, version 2.1.0, March 2011, and CORE v5010 Master Companion Guide, 00510, 1.2, March 2011. (Incorporated by reference in § 162.920).

(2) Phase II CORE 270: Connectivity Rule, version 2.2.0, March 2011. (Incorporated by reference in § 162.920).

(b) Excluding where the CAQH CORE rules reference and pertain to acknowledgements and CORE certification.

[76 FR 40496, July 8, 2011]

HIPAA Regulations

§ 162.1402: Standards for health care claim status transaction

HIPAA Regulations

§ 162.1501: Enrollment and disenrollment in a health plan transaction