Do you conduct HIPAA transactions electronically?

Have you contacted your software vendors regarding HIPAA Version 5010?

Do you know what you have to do to be fully compliant with HIPAA Version 5010?

HIPAA version 5010 is a group of standards that are used when submitting claim information and other healthcare information electronically.  HIPAA requires the Department of Health and Human Services (HHS) to adopt these types of standards for electronic submission of claims and other electronic transfers of healthcare information such as eligibility and claims status requests and responses.

The deadline for compliance with HIPAA Version 5010 is quickly approaching.  Effective January 1, 2012, providers must be ready to submit claims electronically using the Version 5010 Standards, which are not only required for Medicare transactions, but are a pre-requisite for compliance with ICD-10.  You MUST be in compliance if your office conducts HIPAA transactions electronically, such as (but not limited to):

• Electronically checking a patient’s eligibility and/or the status of claims
• Conducting business with a claims clearinghouse or billing service
• Submitting claims electronically

After January 1, 2012, transactions conducted in Version 4010 (the current method of submitting HIPAA transactions) will not be accepted. Providers should begin the implementation process as soon as possible as it may take a few months for software to be set up correctly, to train staff, and to become familiar with the new system themselves.

The ACA has created a HIPAA Version 5010 Implementation Checklist, to assist members with the transition process. In addition, an implementation timeline is available for review at www.acatoday.org/icd10.