What is meant by "electronic transactions"?

Electronic transactions are data exchanges sent electronically between payers, healthcare providers, and clearinghouses. HIPAA requires the use of specific standards for these transactions, which include:

• Claims and claim status
• Remittances (such as payments and explanations of payment)
• Eligibility inquiries and responses
• Authorizations and referrals

Using these standards helps ensure transactions are processed consistently and accurately across healthcare systems.