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  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 09/09/10

The Transition to HIPAA Versions 5010

 

To:​ Participating Medical Assistance Providers​
Date:​ September 9, 2010​
Re:​ The Transition to HIPAA Versions 5010​

 

On January 16, 2009, the Department of Health and Human Services (HHS) Administration published a Final Rule that replaces HIPAA X12 Version 4010A1 with X12 Version 5010. HFS requires all entities both covered and non-covered, that submit transactions electronically, to use the HIPAA X12 standards.  

 

Providers need to share this information with their clearinghouses and business associates, such as billing/service agents. Entities transitioning to Versions 5010 will experience both technical and business changes.

The timeline for implementation of Versions 5010 is shown below:

Provider Education

January 1, 2011

  • A provider notice and companion guide revisions will be released that will outline the modifications associated with the 5010 Versions implementation. 

 

Plans for Testing

 

May 1, 2011

  • Testing will not occur with providers directly. Testing will occur with the department’s trading partners only.

August 1, 2011

  • Dual Processing will be implemented. This will allow providers the capability of submitting claims in the 4010A1 Version or the 5010 Version.

 

Implementation

 

January 1, 2012

  • Cut-off date for old transactions. Full compliance with the 5010 Versions.

Questions regarding this notice should be directed to the Bureau of Comprehensive Health Services at 1-877-782-5565.

 

Theresa A. Eagleson, Administrator
Division of Medical Programs