HIPAA 5010 Readiness – National Testing Week

even fewer are adequately prepared for changes which are coming down the pike.  HIPAA 5010 is one of those changes which promises to pack a big punch as far as organizations and providers are concerned.  HIPAA 5010 will constitute a large change in the way that providers submit claims, as well as the processes for billing procedures….and its implementation is slated to take effect on Jan. 1, 2012. Let’s get started with National Testing Week.

HIPAA 5010 Will Pack a Punch- National Testing Week

What is HIPAA

HIPAA, generally speaking, provides federal protections for personal health information held by health plans, health care clearinghouses, and health care providers.  HIPAA also gives rights to patients/consumers with respect to that protected information.  The U.S. Dept. of Health and Human Services (HHS) also specifies a number of regulations regarding confidentiality, integrity, and availability of this personal health information with regard to electronic medical records

HIPAA 5010- What is the Difference

HIPAA 5010 is more specific in terms of data requirements collected and transmitted with personal health information.  Many of the new requirements deal with a patients location of residence, or address issues.  The mandate will impact how companies, billing providers, and facilities treat postal addresses (for instance PO Boxes are prohibited as a valid billing address, and ZIP codes will be required in their entirety meaning 9 digits, rather than 5).

Who Needs to Be Prepared

As stated, all healthcare organizations will need to be HIPAA 5010 compliant by Jan. 2010, however IT vendors and Data Quality Software Vendors who sell programs to healthcare organizations will also need to be compliant with these changes.  In fact initial surveys point to the fact that healthcare providers are largely leaving the compliance issue up to their outside vendors, counting on them to ensure that all software is able to be updated and ready for the healthcare compliance changes to come, but relying on these vendors could mean potential problems for organizations down the road.

Troubling Statistics

The following information is courtesy of a recent HIMSS survey conducted in Summer 2011

• 35% of providers stated that they had NO Plans in place to implement a HIPAA 5010 readiness project

How to Prepare For National Testing Week

To avoid rejected claims and cash flow interruptions, physicians should prepare for the transition by working with their vendors, clearinghouses, billing services, and payors or upgrade and test their systems and ensure that they are able to successfully implement the new standards prior to the compliance date.

To help practices prepare for the transition, the Centers for Medicare & Medicaid Services (CMS) has announced that Monday, August 22, through Friday, August 26, is National 5010 Testing Week. This is an opportunity for physicians, including their clearinghouse and/or billing service, to test the Version 5010 transactions with the added benefit of real-time help desk support and immediate access to the Medicare Administrative Contractors (MACs). For more information on National 5010 Testing Week, please visit the following link:  5010 Testing Week

For more information on how your organization can be prepared please come back tomorrow, when we will be posting a directory of links for free webinars, HIPAA 5010 blog information, and valuable CMS/HIMSS information.

We look forward to seeing you tomorrow!