The days of sending health care claims forms and claims-related documents by fax and regular U.S. mail are fast drawing to a close.
Last week the Centers for Medicare & Medicaid Services announced that it will adopt a new regulation – “The Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures Final Rule” – that will establish HIPAA-compliant standards for sharing health care claims attachments, enabling the secure electronic exchange of health care claims-related supporting clinical documentation and attachments such as medical records, x-rays and imaging, clinical notes, telemedicine visit documentation, and laboratory results.
The new way means the end of the old ways: using direct mail and fax to transmit such information.
The rule also establishes requirements for electronic signatures to ensure that health care claims attachment transactions are secure, authenticated, and compliant with federal standards.
The new rule does not establish prior authorization attachments standards. CMS says it is still examining how to proceed with those documents.
The standards and mechanisms presented in the rule take effect on May 26 and covered entities must come into compliance with the new requirements by May 26, 2028.
Learn more about the final rule from this CMS news release; an accompanying CMS fact sheet; the final rule itself; and the Healthcare Dive article “CMS sets standards for electronic transfer of claims documentation.”