medicbilling

CMS Sets National 5010 Testing Day For June 15, 2011

In Uncategorized on May 12, 2011 at 6:56 pm

Beginning on January 1, 2012, a federal mandate requires health plans, clearinghouses, and providers to use new standards in electronically conducting certain health care administrative transactions at the heart of daily operations, including claims, remittance, eligibility, and claims status requests and responses.
 
Upgrading from the current HIPAA 4010A1 transaction standards to the new 5010 standards addresses several key goals:

  • Increase transaction uniformity
  • Support pay for performance
  • Streamline reimbursement transactions

As the deadline approaches, affected health care organizations need to upgrade and test their claims management systems to accommodate 5010 and prevent operational disruptions.

Two key factors prompted the upgrade to 5010: 1) the government and industry’s shared goal of providing higher quality, lower cost health care, and 2) the need for a comprehensive electronic data exchange environment for the vastly expanded ICD-10-CM and PCS code set transition mandated for compliance by October 1, 2013.

To this end, the Centers for Medicare and Medicaid Services is encouraging all Medicare trading partners to participate in National 5010 Testing Day on June 15 as part of preparations to comply with the HIPAA 5010 transaction sets by January 2012.

Local Medicare Administrative Contractors will be disseminating information on transactions being tested on June 15 and some Medicaid programs also will participate, with details to come.

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