Standards for data exchange have been developed over the years to help ensure seamless information sharing between enterprises. Part of ensuring your company’s success is making sure you’re able to exchange information between you, your suppliers, your vendors and customers seamlessly.
The Accredited Standards Committee X12 is the organization that develops and maintains these standards. Specific subcommittees handle standards for their respective areas.
Working with the APCD Council, ANSI’s subcommittee on Insurance is currently developing a Uniform Medical Claims Payer Reporting Standard.
14 states have passed legislation to collect health insurance claim and/or remittance information from both public and private payers. This data is being used to develop an All-Payer Claims Database (APCD). Much of this information (including medical, dental and pharmacy claims) is similar to what Medicare and Medicaid requires.
ANSI and the APCD Council see this as a tremendous opportunity to align both of these processes.
In order to currently comply with these requirements, the use of different variations of claims data causes needless delay, especially when going back and forth between state or federal.
To help address industry concerns about this extra burden, ANSI X12 and the APCD Council met on July 12th to start development on an industry-wide implementation guide for effectively addressing these reporting requirements. Much of this meeting focused on considering various business models and discussing the need to develop standardized ‘best-practices.’
Collaborative work is now underway with the next meeting being scheduled for October.
Considering the magnitude of these new standards, it will certainly take a lot of collaboration and time to develop standards healthcare providers can effectively use. Those close to the project hope in the long run it will lower administrative costs for payers and allow states to be seamlessly transfer information.
To learn more specifics about ANSI X-12 and the standards it develops, read our knowledge center article on EDI standards. And if you have any questions or would like to learn more, contact EDI consultants at Innovative Architects today.