Under HIPAA Administrative Simplification, what must covered entities do in relation to submission of claims?

Question

Options

• AProvide standardized format in electronic or paper form
• BRequest permission for use of specific privacy software
• CPurchase and install approved privacy software
• DProvide standardized electronic claim formatting

• A
  2% (1)
• B
  2% (1)
• D
  95% (42)

Explanation

Under HIPAA's Administrative Simplification provisions, covered entities must submit claims using standardized electronic formats (specifically ANSI X12 transaction standards) - making D correct. The key word is electronic: Administrative Simplification was designed to reduce costs by eliminating paper and creating uniform electronic data interchange standards.

Option A is wrong because "electronic or paper form" contradicts the rule - covered entities must use electronic formats, not paper, for standard transactions. Option B is wrong because HIPAA does not require entities to request permission for privacy software; there is no such approval process under Administrative Simplification. Option C is wrong because HIPAA does not mandate the purchase of any specific approved software - entities may use any compliant solution that produces the required standard output.

Memory tip: Think of Administrative Simplification as "standardize and digitize" - its entire purpose was to replace inconsistent, paper-heavy claims processes with uniform electronic submissions, so any answer involving paper or software purchasing is a red flag.

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