Stay informed about the updates applied to PeopleSoft applications to keep your organization compliant

HIPAA 834 EDI is changing - are you prepared?

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As a result of the Health Information Technology for Economic and Clinical Health Act (HITECH) there are significant modifications to the Health Insurance Portability and Accountability Act (HIPAA) which include creating new code and transaction sets for the HIPAA 834 EDI. The Secretary of the Department of Health and Human Services (HHS) has adopted ASC X12 version 5010 and NCPDP version D.0 as the next HIPAA standard for HIPAA covered transactions. The final rule was published on January 16, 2009 with all covered entities to be compliant by January 1, 2012.

The Health Care Industry uses Electronic Data Interchange (EDI) to transfer data. They have developed standards to be implemented consistently by all organizations to facilitate a smooth EDI environment. PeopleSoft Base Benefits adopted the standard Benefits Enrollment and Maintenance transaction ANSI ASC X12.834 version 4, release 1, sub-release 0 to provide standardized data requirements and contents to users of Version 004010 of ANSI ASC X12, Benefits Enrollment and Maintenance (834). The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer.  

The new standard was published for the Benefits Enrollment and Maintenance Transaction ANSI ASC X12.834 version 5, release 1, sub-release 0. A Position Statement was issued to describe the changes that will be made to the PeopleSoft Base Benefits module to allow customers to generate the required 834 transactions on the new standard. These changes will be delivered to our customers on supported releases to 8.81 (with extended support) under the following BUG ID numbers: The targeted release date is by the end of Q3 (end of August beginning of September).

 Release Bug ID
 8.81 (with extended support)11590897

See the Position Statement (Doc ID 1340431.1) in My Oracle Support  for detailed information on what is changing.

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