With the business of today to handle, preparing for a change you must accommodate by Jan. 1, 2012 may not seem a high priority. However, the change to the 5010 version of the HIPAA-compliant electronic transaction standards that must be used as of Jan. 1, 2012 will likely require quite a bit of advanced planning, and 2010 is a good time to start. There will be many steps in the process, many of which will require working with software and hardware support vendors, clearinghouses and payers to upgrade systems and conduct testing.
Every entity that sends or receives electronic transactions such as claims submissions, eligibility inquiries, claims acknowledgments and reports must upgrade to the new standards. So, unless you are lucky enough to be one of the biggest customers of your software and hardware support vendors or have persons internally who provide these services, you may want to start vying for attention early.
To help with your planning, the CMS has put together a checklist that may help you identify the tasks to be performed and create your 5010 transition plan. The checklist provides an example of the steps that may be needed to coordinate upgrades and testing, recognize and plan for expenditures and process changes, and verify successful transmission. Also included are a list of electronic transactions included in the 5010 standard and potential questions to discuss with software vendors/system support staff.
An added benefit of planning now for the transition to the 5010 standards is that implementing them is preparation for the Oct. 1, 2013 adoption of the ICD-10-CM diagnosis code set. The new standards will provide the identifiers necessary for transmission of the ICD-10 codes. Discussions with software vendors about the 5010 transition should also include initial inquiries about the vendors' plans and progress toward an ICD-10 upgrade.
Time flies whether you are having fun or not. Hopefully some early planning and preparation for change will allow for easier transitions and more time for the fun stuff.
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