Today, health care providers and plans use many different electronic formats for electronic transactions. Under HIPAA, the standards for electronic transactions final rule adopts eight electronic transactions and code set standards. Medi-Cal accepts these standards for professional, institutional, and dental claims. The new electronic transaction standards required by HIPAA impact Electronic Data Interchange (EDI) only, and are accredited by the American National Standards Institute (ANSI).

The electronic claim format requirements impact the data that you must submit in order for your claim to be processed. Below is a list of the eight transactions and their corresponding numbers.