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CMS rule to streamline data for insurance eligibility, claim status inquiries

Government Health IT, July 1, 2011
The Centers for Medicare and Medicaid Services has released an interim final rule that describes the standard set of information for two electronic health transactions, one for inquiring about a patient's insurance eligibility and the other on the status of a healthcare claim submitted to an insurer. CMS portrayed the rule as common-sense measures that will save money for doctors, patients and insurers. The health reform law called for the measures to cut paperwork. The new operating rules will provide greater uniformity of information and transmission formats so that physicians and other healthcare providers can use one type of information request for all insurers rather than being required to use multiple systems. It will also make it easier to automate the transactions, CMS said in an announcement June 30.

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