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Make Sure you are Prepared for Version 5010: Risk Mitigation Strategies

All entities covered by the Health Insurance Portability and Accountability Act (HIPAA) that submit transactions electronically are required to upgrade from Version 4010/4010A to Version 5010 transaction standards by Sunday, January 1, 2012. It is important to remember that the upcoming Version 5010 transition is not only mandatory, but is also an integral step toward a successful ICD-10 transition.

It is essential to test both internally and externally with business partners prior to the Version 5010 deadline in order to assure that all trading partners are able to send and receive compliant transactions effectively, and in advance of the transition deadline. Take action now to ensure compliance and avoid problems with submitting claims for reimbursement after Sunday, January 1, 2012.

If you have not yet begun external testing, you should make use of the following risk mitigation strategies:

  • Communicate with vendors and trading partners regularly. Encourage them to take action now and establish a communication plan.
  • Reach out to a clearinghouse for assistance. A clearinghouse ensures that claims smoothly transition between practices and payers and can serve as a translator for non-compliant transactions from the Version 4010/4010A to the Version 5010 system. If you are concerned that your internal systems may not be ready by Sunday, January 1, using a clearinghouse that is already ready to process Version 5010 claims can help ensure your reimbursements are not interrupted while you bring your own systems into compliance.
  • Establish a line of credit. Establishing or increasing a line of credit will help cover potential cash flow disruptions from delayed reimbursement claims.
  • Take advantage of available resources. There are many different resources offering valuable information to organizations looking to streamline their Version 5010 transition. CMS offers several tools to help you plan and execute your transitions to Version 5010 and ICD-10. Beyond CMS, many professional societies and organizations offer guidance and resources to help you transition.

Keep Up to Date on Version 5010 and ICD-10
Please visit the ICD-10 website for the latest news and resources to help you prepare, and to download and share the implementation widget today!




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