Electronic solutions

HIPAA Information

The Health Insurance Portability and Accountability Act (HIPAA) mandates the standardization of EDI formats for health care data transmission, which includes claims, remittance, eligibility and claim status inquiries. HIPAA regulations replace the HCFA 1500 and UB92 Claims formats with ASC X12N 837 Transactions. EDI Services has produced a Companion Guide to assist trading partners in understanding Blue Cross and Blue Shield of North Carolina (BCBSNC) code and situation handling used in processing the ANSI ASC X12N Transactions.

HIPAA regulation has mandated the use of a National Provider Identifier (NPI) for all health care providers by May 23, 2007. BCBSNC requires all healthcare providers to obtain, register, and use an NPI by the Federally mandated compliance date. For more information, see our NPI Pages.