HIPAA Electronic Data Interchange

To achieve federal compliance all Health Insurance Portability and Accountability Act (HIPAA) standard X12 inbound and outbound transactions must use the National Provider Identifier (NPI) to identify providers. These transactions include:

  • the claims transactions (837I, 837P, 837D);
  • the eligibility verification transactions (270/271);
  • the claim status inquiry transactions (276/277);
  • the remittance advice transactions (835); and
  • enrollment transactions (834).

If you have any questions, please refer to the FAQs on this website or contact the Texas Department of Aging and Disability Services (DADS) HIPAA Project Office.

TexMedConnect and Related Documents

DADS continues to work with Texas Medicaid and Healthcare Partnership (TMHP) to provide a quality interface that is HIPAA compliant. For information on the following, visit the links below: