Questions: What organization determines the content of both HIPAA 837 and CMS-1500 claims?

What organization determines the content of both HIPAA 837 and CMS-1500 claims?
Transcript text: What organization determines the content of both HIPAA 837 and CMS-1500 claims?
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Solution

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The answer is the first one (NUCC): the original text in the question...

Explanation for each option:

  • NUCC: The National Uniform Claim Committee (NUCC) is responsible for determining the content of the CMS-1500 claim form, which is used by non-institutional providers to bill Medicare and other health insurance programs. The NUCC also plays a role in the standardization of the HIPAA 837 claim form, which is the electronic version of the CMS-1500.
  • HIPAA: The Health Insurance Portability and Accountability Act (HIPAA) sets standards for the protection of health information and the electronic transmission of healthcare data, but it does not determine the specific content of claim forms.
  • NPI: The National Provider Identifier (NPI) is a unique identification number for healthcare providers, but it does not determine the content of claim forms.
  • CMS: The Centers for Medicare & Medicaid Services (CMS) oversees the administration of Medicare and Medicaid programs and provides guidelines for claim forms, but the specific content of the CMS-1500 and HIPAA 837 forms is determined by the NUCC.

Summary: The organization that determines the content of both HIPAA 837 and CMS-1500 claims is the NUCC (National Uniform Claim Committee).

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