Administrative Simplification works to streamline administrative health care transactions and set standards for transmitting electronic health information. The National Standards Group (NSG) within the Office of Burden Reduction & Health Informatics (OBRHI) enforces Administrative Simplification standards, which aim to reduce burden and lower costs by standardizing business practices.
NSG administers HIPAA Administrative Simplification requirements related to the format and content of electronic, administrative health care transactions, such as claims and payments.
HIPAA Administrative Simplification statutory and regulatory provisions include adopted standards and additional requirements for covered entities that conduct electronic health care transactions.
This guidance is a line of tools designed to help HIPAA covered entities, their partners, and the health care community comply with statutory and regulatory requirements for standards for electronic health care transactions and operating rules.
Covered entities performing administrative electronic health care transactions must follow Administrative Simplification statutes and regulations, including adopted standards. Learn how these standards are adopted and updated.
A code set is a shared list of codes used in place of longer names or explanations. We enforce code sets for diagnoses and procedures used in all electronic health care transactions.
Operating rules are necessary business rules and guidelines for the electronic exchange of information not defined by a standard or its implementation specifications.
NSG enforces Administrative Simplification requirements through compliance reviews and responding to complaints of potential noncompliance filed through the Administrative Simplification Enforcement and Testing Tool (ASETT). Learn how you can file a complaint or test a transaction for compliance.
Identifier requirements apply to employers and providers to standardize the identification of those conducting electronic health care transactions.