What is another term for a HIPAA-mandated electronic transaction for claims?

The term HIPAA X12 837 Health Care Claim refers specifically to the standardized electronic format mandated by the Health Insurance Portability and Accountability Act (HIPAA) for submitting healthcare claims to payers. This format is designed to facilitate electronic transactions between healthcare providers and insurers, ensuring that claims are processed efficiently and accurately.

This standardized format helps streamline the billing process, reduces paperwork, and minimizes errors that can occur with manual claims submission. The X12 837 transaction set is part of a series of standards developed by the Accredited Standards Committee (ASC) X12 and is integral to the electronic data interchange (EDI) in healthcare.

While the other options listed relate to claims submission, they do not specifically denote the HIPAA-mandated electronic transaction format. The CMS 1500 and HCFA 1500 refer to paper claim forms used for submitting claims, and EDI is a broader term that encompasses the electronic exchange of data in many formats, not limited to HIPAA transactions. Therefore, the HIPAA X12 837 Health Care Claim is the precise term that aligns with the question.