HIPAA v5010 Electronic Billing Standard
Federal compliance requirements in effect from January 1, 2012
Therap’s Electronic Billing system has been successfully upgraded to support HIPAA 5010 compliance requirements. Click here to download a summary of changes that will guide you towards a smooth transition to HIPAA 5010 Electronic Billing.
The Electronic Billing service assists providers funded by Medicaid. Agencies can create and send professional claims for a single or multiple individuals and for one or more of their service lines. When users create new claims or update existing ones, the invoices are available to them in PDF format which they can have printed out.
- Claims submitted by a Billing provider is sent to state Medicaid directly.
- Users can view status of their claims to check if they have been accepted.
- Rejected claims are sent back to Provider agencies to be resubmitted after making corrections.
- Transaction Record feature lets users search for claims for a particular transaction along with their current status.
Professional and Institutional Claim Generation
Therap Billing system allows for HIPAA compliant submission of professional and institutional claims. The system is capable of producing claims in ANSI X12 837 format. It also updates claim status based on X12 835s received from the Medicaid system.
- If claims are denied, user can resubmit them for single or multiple Individuals after making necessary corrections.
- Claims can also be generated as a PDF file for submitting manually to a payer.
- Using Therap’s Billing Application, users can create billing templates for recurring claims(837 Institutional Claim Type).
Therap has Trading Partner Agreements with MMIS vendors, ACS Gateway, EDS/HP & CSC for Medicaid Claim submission in several states. Therap acts as a Billing Agent for providers in Alaska, Colorado, Delaware, Florida, Georgia, Kansas, Minnesota, New York, Pennsylvania, and Wyoming.
Billing Units & Calculation
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