Standards and Specifications Overview

UHIN hosts the UHIN Standards Committee. The Standards Committee meets on a monthly basis and focuses on the development of community-based health care data Standards. Traditionally, the UHIN Standards Committee has focused on administrative transactions such as electronic claims submission and payment.

The UHIN Standards Committee is comprised of representation from the health industry in Utah - health care payers, providers, sponsors (employers) and others participate in the UHIN Standards Committee. All members of the Utah health care community are welcome to attend. The UHIN Standards Committee members raise, negotiate, and vote on UHIN Standards. Often this is a long process.

Once the UHIN Standards Committee approves a Standard, it is forwarded to the UHIN Board of Directors. The Board of Directors then votes on each Standard. If the Standard is approved, there is a 30 day waiting period wherein any UHIN member can voice an objection to the proposed Standard. After 30 days, the Standard is officially adopted by UHIN. All Standards are subject to change if substantive reasons develop. In this case, the Standard is again reviewed and, if necessary, changed by the UHIN Standards Committee and then re-submitted to the Board.

The Utah Insurance Department (UID) is required by state law to adopt standards for health care claims and related issues. UID has chosen to adopt UHIN's Standards as state standards. Once the UHIN Board of Directors approves a Standard, it is forwarded to UID for their review. UID formally re-opens the rule on uniform claims and holds a public hearing on whether to adopt the proposed UHIN Standard. If no substantive objections are raised, UID adopts the UHIN Standard as State rule.

UHIN Specifications are practices or standards that only apply to members of UHIN and do not become State rules.