5010 CONVERSION DEADLINE - What You Need to Know to Prepare ~

Your practice cannot afford to fall behind in the race to beat the 5010 Conversion Deadline of January 1, 2012.

Make your partner:

ASK YOURSELF:

• Do you have a billing platform currently that includes acknowledgment of transactions 999 and 277CA?
• Do you have a billing platform in place to include “readable” error reports produced from the 277CA and 999 transactions?
• What are YOUR plans and timeframes for implementing 5010?
  
• Will you be able to support the 4010A1 and 5010 transactions concurrently?
• Are you prepared to conduct internal testing?

HIPAA 5010 / ICD-10 Readiness:

The Federal government mandated that all covered entities (including proiders, clearinghouses and health plans) must transition to the latest version of the Health Insurance Portability and Accountability Act (HIPAA) electronic transaction standards and code sets.
The Centers for Medicare & Medicaid Services (CMS), which oversees compliance with the HIPAA transactions and code sets, has made it VERY CLEAR that there will be NO delay with the 5010 Compliance deadline.

IF YOU ARE NOT PREPARED FOR THE 5010 TRANSACTION, YOUR PAYMENTS WILL EITHER BE DENIED OR SIGNIFICANTLY DELAYED OR LOST ENTIRELY.

ASK YOURSELF:  CAN YOU AFFORD FOR THE TO HAPPEN TO YOU?

• JANUARY 1, 2012:  The 5010 version of the electronic transactions standards will replace the current 4010 version.
• OCTOBER 1, 2013:  The International Classification of Diseases 9th Revision, Clinical Modification (ICD-9-CM), the current code set for reporting diagnosis, will be REPLACED by the ICD-10-CM.

KEY Transaction areas affected by the 5010 Implementation:

• Eligibility
• Claim Inquiry
• Authorization and Referral
• Premium Payment
• Enrollment
• Remittance
• Claim Submission

HIPAA updates from version 4010 to 5010 are well underway.  As you know, these changes seek to reduce the administrative burden of health care by increasing the consistency, accuracy and efficiency of electronic transaction interchanges.