The CMS Office of E-Health Standards and Services will end its enforcement discretion period for Version 5010 standards on June 30, 2012, at which time all HIPAA-covered entities must be fully compliant with all of the upgraded transaction standards for Version 5010. If you have not yet finalized your Version 5010 upgrade, you should be working to do so as soon as possible.
As of July 1, 2012, non-compliant entities will face claim rejections, and complaints received through CMS’s HIPAA Administrative Assistance Enforcement Tool will result in enforcement action. CMS has announced however, that Medicare fee-for-service will be allowing an additional 30 days to move to the 5010 version for the electronic remittance advice transaction only.
According to CMS, health plans, clearinghouses, providers and software vendors have demonstrated broad collaboration in recent months to resolve some of the technical challenges affecting implementation. Physician offices are encouraged to reach out to clearinghouses and health plans to determine if your claims are fully compliant with the new 5010 format and to make any necessary workflow changes prior to June 30.
The OMA has been working hard to track problems and assist medical practices throughout Oregon who are experiencing problems caused by the 5010 transition. Practices that continue to experience claims processing delays, cash flow interruptions or other problems caused by the 5010 transition are encouraged to contact Gabriella Tagliacozzo at gabriella@theOMA.org or (503) 619-8000.
CMS to host 5010 webinar June 20
The CMS Regional Office will also host a Version 5010 webinar for health care providers, clearinghouses and vendors on June 20 from 1:00 to 2:00 pm. The webinar will cover current conversion statistics; final 5010 preparations; operational concerns; future Electronic Data Interchange (EDI) communications; and important resources and contacts. Learn more and register at http://registration.intercall.com/go/cms2.
For more 5010 information and resources from CMS, visit http://go.cms.gov/Lwshr1.