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What is the format of electronic claims transmission, which are routed between provider and billing company, clearinghouse, or payer using the Internet or other packet-exchange network?

a) EDI (Electronic Data Interchange)
b) XML (Extensible Markup Language)
c) JSON (JavaScript Object Notation)
d) HTML (Hypertext Markup Language)

1 Answer

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Final answer:

The electronic claims transmission format used in healthcare between various parties is EDI (Electronic Data Interchange). EDI complies with healthcare regulations and enables secure, standardized transactions for claims and payments.

Step-by-step explanation:

The format of electronic claims transmission, which are routed between provider and billing company, clearinghouse, or payer using the internet or other packet-exchange network, is a) EDI (Electronic Data Interchange). EDI is a standard for exchanging healthcare information electronically. This system allows providers to submit insurance claims, get authorizations, and receive payments in a secure, standard format that is accepted universally by payers in the healthcare industry. While other formats like XML, JSON, and HTML have their places in data transmission, EDI remains the cornerstone for medical claims and other healthcare-related transactions due to its compliance with strict regulations and standards such as HIPAA.

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