HIPAA 5010 from your perspective

According to the federal timeline, organizations should be nearing completion of level 1 testing in late 2010 and beginning testing with trading partners in January 2011.

Meeting the deadlines, though, means health care organizations need to implement new electronic transaction software that can handle the upgrade. The same is true for systems that currently utilize ICD-9 codes. Before hospitals, physicians, health plans, and others can use the new code sets, they must upgrade their electronic systems to be compatible. The organizations that will realize the benefits of 5010 more quickly are those that plan ahead, use innovative technology, and meet the recommended deadlines dictated by CMS.

How can health organizations do this? Inventory your systems to determine which ones will be impacted by the change, communicate with information systems vendors to determine whether upgrade plans are sufficient, evaluate clearinghouses and other business partners to gauge 5010 readiness, and test, certify and validate all your EDI transactions for compliance. To learn more, follow the links below.

For Health Plans

Upgrading to 5010 transaction standards means implementing new software that can accommodate the upgrade—and making sure trading partners are equally prepared—to avoid operational disruptions.

For Physicians

HIPAA 5010 represents a significant, though challenging, opportunity to reduce administrative burdens by eliminating disparities between billing and reimbursement systems.

For Hospitals

The new transaction standards—and system upgrades that manage them—also bring opportunities to simplify and enhance their revenue stream through consistent formats and processes.

For Government Agencies

Improvements in data content under HIPAA 5010 will translate to enhanced efficiencies and a shorter revenue cycle.