Agencies
Services
Provider Notice dated 12/14/11
To: |
All Medical Assistance Providers |
Date: |
December 14, 2011 |
Re: |
HIPAA 5010 Transaction Standards Implementation Timeline |
Effective with claims submitted on and after January 1, 2012, providers are mandated to convert from the HIPAA X12 4010A1 to version 5010 and NCPDP 5.1 to version D.0 electronic billing formats. This notice announces that some transactions are available now and provides implementation dates for the remaining transactions.
Implementation Timeline
The following are key dates for the implementation of 5010 transactions for HFS.
NCPDP – Pharmacy transactions (D.0 and 1.2) – In Production
837I – Health Care Claim (Institutional) – In Production
837P – Health Care Claim (Professional) – In Production
276/277 – Claim Status Request/Response – In Production
270/271 – Eligibility Request/Response – January 1, 2012
835 – Payment and Remittance Advice – January 1, 2012
Please note that any 835 files created for HFS vouchers generated prior to January 1, 2012, will be in the 4010A1 format. January 1, 2012, will mark the beginning of the 5010 format.
Dual Processing of 4010 and 5010 Transactions
HFS will be maintaining dual processing once all transactions are implemented on January 1, 2012, except for the 835. Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin on November 17, 2011, which allows dual processing through March 31, 2012.
Direct Data Entry (DDE) 5010 Transactions
DDE does not accommodate dual processing.
For current updates to the 5010 transition, EDI transaction issues, FAQs and links to Companion Guides, please see the new EDI Page. HFS also welcomes comments, as to more efficient ways to assist you, providing answers across this new Web site page.
Any questions regarding this notice may be directed to the provider's medical assistance consultant in the Bureau of Comprehensive Health Services at 1-877-782-5565.
Theresa A. Eagleson, Administrator
Division of Medical Programs