Claims Transmission ANSI 5010

What is ANSI 5010?
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 forthcoming ICD-10 coding. The Centers for Medicare and Medicaid Services (CMS) requires that all entities covered under HIPAA conform to the new 5010 standards by January 1, 2012. Similar to the National Provider Identifier (NPI) transition, practices will need to upgrade their practice management solution in order to be compliant with ANSI 5010.

Who does the ANSI 5010 change affect?
The ANSI 5010 change affects physicians, payors, software vendors and clearinghouses/ third-party billers.

When must the transition to ANSI 5010 be completed?
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.

What is the urgency to upgrade my practice management system?
Significant changes have been made to McKesson’s Medisoft® and Lytec® 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 the software, the implementation of the compliant versions will be more complex and time-consuming than previous upgrades. In addition, testing of the new ANSI 5010 standards has already begun. By upgrading now, you can take advantage of the testing period and ensure that your claims are compliant in advance of the deadline.

How can The Creative Network help?
At The Creative Network, we are here to help your practice transition to ANSI 5010. LYTEC 2011 is our ANSI 5010-compliant release. LYTEC 2011 is scheduled to be released in March 2011. Don’t wait to start preparing. Call us today at (818) 942-0123 or visit our website, www.TheCreativeNetworks.com to find out more.