HIPAA EDI transaction is a part of HIPAA EDI rule that involves electronic exchange of information between two or more parties to carry out financial or administrative activities in the healthcare sector. The transmission of electronic documents between patients, healthcare providers, and other involved parties is done through an EDI mode of communication, such as email, FTP, and HTTP. Communication that is not HIPAA EDI defined is used to classify electronic business documents.
Under the HIPAA EDI rule, the Department of Health and Human Services (HHS) adopts standard rules for the electronic exchange of healthcare data between covered entities and business associates. The transactions include claims status, payment & remittance advice, premium payment, enrollment & disenrollment, eligibility, coordination of benefits, and referrals & authorizations.