Under HIPAA, a transaction of information between two parties for the purpose of carrying out financial or administrative activities related to health care can include the following types of transmission:
- health care claims or equivalent encounter information;
- health care payment and remittance advice;
- coordination of benefits;
- health care claim status;
- enrollment and disenrollment in a health plan;
- eligibility for a health plan;
- health plan premium payments;
- referral certification and authorization;
- first report of injury;*
- health claims attachments;*
- other transactions that may be prescribed by regulation.
*Currently, HIPAA has stayed, or delayed implementation of, first reports of injury and health care claim attachments as covered HIPAA transactions. Note: Although an occupational health nurse may fax or electronically transmit a first report of injury, doing so does not make him or her a "covered entity" under HIPAA. This transmission generally is related to the physician’s first report of injury for which the physician will receive payment for services rendered.