The Department of Health and Human Services (HHS) recently introduced an interim final rule standardizing certain electronic transactions to save $12 billion and give providers better access to patients’ health care information.

The rule requires health plans, health care clearinghouses and certain health care providers to implement by Jan. 1, 2013, standards (“operating rules”) for two electronic health care transactions under the Health Insurance Portability and Accountability Act (HIPAA): eligibility for a health plan and health care claim status. It implements certain administrative simplification provisions of the Patient Protection and Affordable Care Act (PPACA, P.L. 111-148 and P.L. 111-152).

The electronic operating rules were designed to make it easier for providers to determine patients’ health care coverage eligibility and the status of health care claims submitted to health insurers, the HHS reported.

The rule will save health care providers and health insurance companies money, allow doctors to spend more time on patient care than administration, and give consumers more complete information about their out-of-pocket costs and deductibles, according to the HHS.

Doctors spend about 12% of every dollar they receive from patients to cover the costs of excessive administrative complexity, according to a May 2010 study in Health Affairs. The study found that simplifying these systems could save four hours of professional time per doctor and five hours of support staff time every week.

The HHS estimated that the implementation costs to providers could approach $800 million throughout 10 years, but that the health care industry could save about $12 billion by the next decade because of reduced transaction costs and denied claims.

The HHS will accept comments on the interim final rule through Sept. 6, 2011, and indicated any changes will be finalized no later than Jan. 1, 2012.

The interim final rule follows operating rules developed by the Council for Affordable and Quality Healthcare’s Committee on Operating Rules for Information Exchange (CAQH CORE), a health industry coalition.

Other operating rules streamlining and simplifying the health care system that the HHS hopes to implement in the future are: standards and operating rules for electronic funds transfer and remittance advice; a standard unique identifier for health plans; a standard for claims attachments; and requirements that health plans certify compliance with all HIPAA standards and operating rules.