HIPAA Version 5010 - Are You Ready?

The Enforcement Of The New HIPAA 5010 Transactions Has Been Delayed Until June 30, 2012. Are You Ready To Transit?

The transactions used conduct the business of health care (eligibility checking, claims, payments, etc) are being upgraded to new versions, ASC X12 Version 5010 and the companion NCPDP v D.0 and 3.0, so that claims information can be transmitted using the upcoming ICD-10 codes. Before ICD-10 can be used, everyone needs to be doing business using the updated 5010, D.0, and 3.0 transaction sets. The use of the new transactions has been required since January 1, 2012, but enforcement of the rule has been delayed until June 30, 2012 because not all providers and clearinghouses are ready to use the new transactions.

Everyone involved in conducting the business of health care should be asking their software vendors if their systems can use 5010/D.0 transaction sets, and how well they can support the transition to the new transactions. Likewise, any clearinghouses used should be queried as to their readiness, since a lack of coordination could lead to delayed revenues. Using the new standards means making many changes to business practices. There may be changes required for workflow, and training for your staff to handle the changes. In addition, any hiccups in the transition could lead to cash flow problems, so there is a strong financial incentive to be ready and coordinated with payers.

Register now and our expert speaker Jim will work through guides and check lists for the transition to the new transactions, including planning, discovering the systems that use transactions, finding out who the payers are and what their plans are, and determining what needs to be tested, and what needs to be changed in business processes. Different “levels of compliance” and how they should be met will be discussed, and readiness assessment tools will be examined. Planning for contingencies in cash flow will be discussed, and special issues for dealing with Medicare Administrative Contractors will be explored.  l Also learn to explain why the changes are taking place, and what benefits will accrue to the industry and to health care by making the changes. Numerous resources for guides, checklists, and other supporting information will be provided.

• The new HIPAA transaction sets are designed to support the use of an expanded code set, ICD-10, necessary to provide sufficient detail to efficiently handle health care information in a meaningful way – we will discuss the new transactions and code sets and their benefits.
• The HIPAA 5010 transactions are due for enforcement after June 30, 2012, and not all entities are prepared – we will discuss how to know if you are prepared or not.
• Using HIPAA 5010 transactions requires close coordination between various entities to ensure claims and payments are processed properly and in a timely fashion during the transition – we will discuss how to find out who is involved in your transactions and how prepared they are.
• The transition to the new transactions needs to be carefully planned, and financial contingencies must be planned for – we will discuss how to plan your transition process.
• Medicare has its own set of requirements and timelines within the rules – we will discuss some of the finer points of interaction with your Medicare Administrative Contractor (MAC).
• Timelines for transitions are key, and penalties can result if transitions don’t go well – we will explain everyone’s responsibilities and reasonable expectations of each other in the process.
• If your transition isn’t going well, and your revenues are interrupted, you will want to complain – we will describe how to get action when your trading partners aren’t doing their part.

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Who should attend? Compliance Manager, HIPAA Officer, Chief Information Officer, Health Information Manager, Medical Office Manager, Medical Practice Lawyer, CFO, CEO, COO. Privacy Officer, Information Security Officer.

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