Section 1104 of the Administrative Simplification provisions of the Patient Protection and Affordable Care Act (a/k/a Affordable Care Act, ACA) established new requirements for administrative transactions that will enhance the usefulness of existing HIPAA transactions and reduce administrative costs.
In Section 1104(b)(2) of the Affordable Care Act, Congress required the adoption of new operating rules for the health care industry. To create as much uniformity as possible in the implementation of electronic standards, Congress directed the U.S. Secretary of Health and Human Services to adopt a single set of operating rules for each transaction.
- All Provider Bulletin 239: Affordable Care Act Operating Rules
- Electronic Funds Transfer Enrollment/Modification Form [EFT-1]
- EFT Enrollment/Modification Form Instructions
- Electronic Remittance Advice Enrollment/Modification Form [ERA-1]
- ERA Enrollment/Modification Form Instructions
Claim Adjustment Reason Codes and Remittance Advice Remark Codes
- CARCs & RARCs Effective 01.01.2015 file size 3MB
This information is provided by MassHealth.