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   >   Enrollment And Disenrollment In A Health Plan

§ 162.1502 Standards for enrollment and disenrollment in a health plan transaction

The Secretary adopts the following standards for enrollment and disenrollment in a health plan transaction.

(a) For the period from October 16, 2003 through March 16, 2009: ASC X12N 834–Benefit Enrollment and Maintenance, Version 4010, May 2000, Washington Publishing Company, 004010X095 and Addenda to Benefit Enrollment and Maintenance, Version 4010, October 2002, Washington Publishing Company, 004010X095A1. (Incorporated by reference in § 162.920.)

(b) For the period from March 17, 2009 through December 31, 2011, both:

(1) The standard identified in paragraph (a) of this section; and

(2) The ASC X12 Standards for Electronic Data Interchange Technical Report Type 3– Benefit Enrollment and Maintenance (834), August 2006, ASC X12N/005010X220 (Incorporated by reference in § 162.920)

(c) For the period on and after January 1, 2012, the standard identified in paragraph (b)(2) of this section.

[74 FR 3327, Jan. 16, 2009]

HIPAA Regulations

§ 162.1501: Enrollment and disenrollment in a health plan transaction

HIPAA Regulations

§ 162.1601: Health care electronic funds transfers (EFT) and remittance advice transaction