HIPAA Compliance: Meeting Government Guidelines
Our software is tested by Claredi Classic, the industry-leading and first comprehensive HIPAA testing solution for pre-production transaction testing and certification. Our HIPAA transaction sets are Tested and Certified to ensure your EDI transactions are compliant with standards, regulations and payer requirements..
Claredi certifies the most recent National Standards for Transactions Data Sets required for electronic submission of Nursing Home claims. Their certification ensures that our software complies with the specification mandated by intermediary and government agencies.
ADL provides additional layers of security and login on top of the Windows Active Directory to ensure that our Extensive security features restrict unauthorized users from logging into and accessing the system and
HIPAA regulations require the use of special identification numbers. ADL software supports both the EIN and the UPIN numbering methods.
National Provider Identifier (NPI)
A universal identifier used to enumerate all types of health care providers, and supporting data structure that incorporates a comprehensive list of provider types developed by an ANSI Accredited Standards Committee X12N workgroup.
Employer ID Number (EIN)
The national employer identifier EIN number identifies the employer in health transactions.
Medicaid State Approvals
For those states that do not comply with HIPAA Transaction sets, ADL Data partners with several major clearinghouses to support all the State Medicaid Invoicing systems.
Currently Intermediaries only accept Transaction/Code Sets for Medicare-A, Medicare-B and Physician Billing. So while other Transaction/Code Sets have been developed, the services from the Intermediaries are not in place.
ADL transaction code tables are based on ANSI ASC X12N HIPAA Implementation Guides.
|276||Claim Status Request||Yes|
|277||Claim Status Response||Yes|
|278||Claim Review Request||Yes|
|278||Claim Review Response||Yes|
|820||Premium Payment||Not Applicable|
*This guide is available at the Washington Publishing Company’s website