The Health Insurance Portability and Accountability Act (HIPAA) requires that Medicaid and all other health insurance payers in the United States comply with the EDI standards for healthcare as established by the Secretary of Health Services. The ANSI X12N implementation guides (4010) and Technical Report Type 3-TR3 documents (5010) have been established as the standards of compliance for claim transactions.

This page provides access to information intended to serve only as a companion guide to the HIPAA ANSI X12N implementation guide and TR3 documents. The use of this guide is solely for the purpose of clarification. The information describes specific requirements to be used for processing data. This companion guide supplements, but does not contradict any requirements in the X12N implementation guide or TR3 document.

Additional information on the Final Rule for Standards for Electronic Transactions can be found at http://aspe.hhs.gov/admnsimp/final/txfin00.htm. The HIPAA implementation guides and TR3 documents can be purchased from the Washington Publishing Company Web site at http://www.wpc-edi.com/hipaa/HIPAA_40.asp. Additional information related to HIPAA is also available on the Department of Community Health Web site at www.dch.georgia.gov.

The information in these guides is subject to change. Please check this site periodically to obtain the most current information available from Georgia Medicaid. If you have any questions regarding these companion guides, please contact EDI Services at (877) 261-8785 (toll-free) or (770) 325-9590 (locally).