Health Care Claim Payment/Advice (835) Infrastructure Rule

80.1 - Health Care Claim Payment/Advice (835) Infrastructure Rule (Rev. 3288, Issued: 07-02-15, Effective: 08-03-15, Implementation: 08-03-15) Section 1104 of the Patient Protection and Affordable Care Act (ACA) establishes the development and implementations of “requirements for administrative transactions that will improve the utility of the existing HIPAA transactions and reduce administrative costs.” A/B MACs/ CEDI/ and DME MACs are required to conform to the following CAQH Core Operating Rules impacting the transmittals of X12 835 transactions. A complete list of ACA mandated operating rules are available at http://www.caqh.org/ORMandate_index.php.