ANSI 5010 is the new version of HIPAA transaction standards that regulates the electronic transmission of healthcare transactions. The 5010 standards will replace the existing 4010/4010A1 version of HIPAA transactions and address many of the shortcomings in the current version, including the fact that 4010 does not support the newer ICD-10 coding.
By January 1, 2012, practices will need to complete electronic transactions in an ANSI 5010-compliant format. These electronic transactions include claims, eligibility inquiries and remittance advices. Failure to comply may result in denied claims, slower payments and increased customer service issues.
Significant changes have been made to practice management systems to comply with the new ANSI 5010 standards. These changes affect the amount of data and the way data is stored in the systems as well as your practice workflow. If you are on an older version of your EMR software, the implementation of the compliant versions will be more complex and time-consuming than a typical upgrade. In addition, testing of the new ANSI 5010 standards has already begun. Depending upon your provider you may be able to upgrade now to take advantage of the testing period and ensure that your claims are compliant; in advance of the deadline.
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