As hospitals, physicians, software vendors, clearinghouses and payors gear up for HIPAA Version 5010, which will go live on Jan. 1, 2012, the Healthcare Billing and Management Association (pdf) offered 10 definitions in a letter to CMS of what it means to be "ready" for Version 5010.
Providers and clearinghouses are "5010 ready" when they complete the following items:
• Completion of all practice management system upgrades.
• Confirmation of successful testing with direct submission carriers.
• Confirmation of successful testing with clearinghouses where applicable.
• Confirmation of successful production submission of claims.
• Confirmation of successful retrieval of the claims' associated remittance.
Payors and clearinghouses are "5010 ready" when they complete the following items:
• Completion of all system upgrades.
• Confirmation of successful testing with direct submitting providers.
• Confirmation of successful testing with clearinghouses where applicable.
• Confirmation of successful acceptance of production claims submission.
• Confirmation of successful return of the claims' associated remittance.
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Providers and clearinghouses are "5010 ready" when they complete the following items:
• Completion of all practice management system upgrades.
• Confirmation of successful testing with direct submission carriers.
• Confirmation of successful testing with clearinghouses where applicable.
• Confirmation of successful production submission of claims.
• Confirmation of successful retrieval of the claims' associated remittance.
Payors and clearinghouses are "5010 ready" when they complete the following items:
• Completion of all system upgrades.
• Confirmation of successful testing with direct submitting providers.
• Confirmation of successful testing with clearinghouses where applicable.
• Confirmation of successful acceptance of production claims submission.
• Confirmation of successful return of the claims' associated remittance.
Related Articles on Version 5010:
National Version 5010 Testing Week: The Good and Bad NewsHow to Make Sure Your Hospital is Level II Compliant With Version 5010
CMS Reports National Version 5010 Testing Week Had No Significant Errors