HIPAA 5010 | New Health Care Electronic Transactions Standard

Achieving HIPAA 5010 compliance is the first step in transitioning to ICD-10-compliant health care claims systems. The deadline for physician practices to achieve HIPAA 5010 compliance – and avoid a breakdown in claims payment and the threat of federal fines – is January 1, 2012.

Many practices are a long way from achieving HIPAA 5010 compliance, and some don’t even have a plan for getting there.

The solution is to work with a Medical Billing and practice management service that will not only guide you toward 5010 (and ultimately ICD-10) compliance, but one that will also make your medical billing and practice management system compliant and take on the burden of overcoming obstacles– without charging additional fees.

Prepare for HIPAA 5010

What Practices Can Do Now

The biggest concern for practices will be complete implementation and full functionality of the 5010 transactions at or before the compliance deadline to avoid transaction rejections and subsequent payment delays. Practices can begin now to prepare for this upcoming effort by developing their own implementation plan. The following are various tasks to include in an implementation plan.

  1. Talk to your current practice management system vendor.
  2. Talk to your clearinghouses or billing service, if you use either one, and health insurance payers.
  3. Identify changes to data reporting requirements.
  4. Identify potential changes to existing practice work flow and business processes.
  5. Identify staff training needs.
  6. Test with your trading partners, e.g., payers and clearinghouses.
  7. Budget for implementation costs, including expenses for system changes, resource materials, consultants, and training.