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 Posts Tagged ‘5010 compliance’

As of January 1, 2012, health care providers, payers, software vendor (e.g., Therap), and clearinghouses/third-party billers – must conduct all electronic HIPAA transactions using Version 5010 standards, according to CMS requirements.

Therap’s electronic billing system is ready to handle 5010 transactions. Therap is, and will continue to provide necessary support and training to all our users.

Looking onward the next task is to move on to ICD-10 codes for medical diagnosis and inpatient procedures by October 2013. Between then and now, a number of milestones will have to be achieved by everyone involved. A detailed timelines of activities on the path to Version 5010 and ICD-10 compliance, is provided by CMS here. CMS is also offering a desktop and mobile app for this purpose that you should definitely check out.

Its almost new year and from the very first day of 2012, providers will have to comply with HIPAA v5010 standard for electronic billing transactions. This is not optional – providers are required to do this under federal law.

In the previous post, we have announced that Therap’s Electronic Billing system is now ready for 5010 compliant transactions. Here is a brief summary of changes, do’s and don’ts in the new 5010 complaint system –

Do’s
• Must enter a 9-digit zip code in the Provider Address section on the Billing Provider form.
• Must enter Primary Diagnosis Code and Diagnosis Code Pointer in Service Description/Code form.
• While creating new Institutional Claim Templates, Admission Type and Patient Status must be selected.

Don’ts
• Must not enter P.O. Box as street address in the Provider Address section in the Billing provider form.

Please note that claims WILL be rejected if these do’s and don’ts are not strictly followed. Details regarding these changes, along with screenshots are provided in this document -

Therap Electronic billing software, has been approved for HIPAA v5010 professional claim production by EDS, the MMIS vendor in Delaware, as of December 8, 2011.

With this transition, HCBS/DD providers in the state will be able to send HIPAA v5010 compliant electronic claims directly to DMAP – the Medicaid system in Delaware.

HIPAA v5010  is the latest transaction standard that all developmental disabilities providers, will have to transition to by January 1, 2012, as required by the Centers for Medicaid & Medicare Services (CMS).

Therap Medicaid billing software, has been approved for HIPAA 5010 professional claim transactions in Wyoming by ACS/Xerox – the MMIS fiscal agent in the state.

With this update, providers supporting people with developmental disabilities will be able to send ASC X12 version 5010 compliant professional claims to Wyoming Medicaid.

HIPAA 5010  is the latest transaction standard that all developmental disabilities providers, will have to transition to by January 1, 2012, as required by the Centers for Medicaid & Medicare Services (CMS).

Therap’s Electronic Billing solution, has been approved for ASC X12 version 5010 transactions by Electronic Data Systems (EDS), MMIS vendor in Florida, as of November 22, 2012.

This will allow HCBS/DD Waiver service providers under Florida APD to submit 5010 compliant professional claims directly to Florida Medicaid.

ASC X12 version 5010 is the latest HIPAA transaction standard. All developmental disabilities support providers, as well as other covered entities, will have to transition to version 5010 by January 1, 2012.

Therap’s Electronic Billing software is now HIPAA 5010 ready for developmental disabilities support providers in New York.

As of November 16, 2011, The Computer Sciences Corporation (CSC), eMedNY and Trading Partner Service provider in New York, has approved Therap’s ASC X12 version 5010 electronic transactions for submitting institutional claims to New York State Department of Health (NYDOSH).

With Therap Electronic Billing, institutional claims can be directly sent to the eMedNY (Electronic Medicaid of New York) system.

In addition to producing claims, users are able to track claim status and view remittance reports.

ASC X12 version 5010 is the latest HIPAA transaction standard. All developmental disabilities support providers  and other covered entities will have to transition to 5010 by January 1, 2012.

KMAP’s (Kansas Medical Assistance Program) EDI team has approved Therap’s ASC X12 version 5010 compliant software for claim production as of November 7, 2011. In addition to producing claims, users are able to track claim status and view remittance reports.

Therap’s comprehensive electronic billing solution handles the entire billing process for providers, covering service authorizations, billing/attendance records management, claim submission and status tracking. The electronic billing system supports the Kansas Day Habilitation per diem unit calculation and the unique Targeted Case Management unit calculation methods utilized by KMAP.

Therap’s ASC X12 version 5010 electronic billing has also been approved by EDS, MMIS vendor in Florida and Computer Sciences Corporation (CSC) – Trading Partner services provider in New York.

With Florida APD moving into quarterly service authorizations with the iBudget system, Therap’s electronic billing will be helpful for HCBS/DD waiver service providers in the state to maximize utilization.

In New York, the 5010 compliant billing system will be useful for Day Hab, Res Hab, IRA, Pre Vocational and other ID/DD service settings by allowing them to submit and track Medicaid claims. Therap also supports the Hab Checklist for users in New York.

In the coming weeks, Therap’s 5010 electronic billing system will be ready for the States of Colorado, Wyoming, Delaware and Alaska.