Are You 5010 Compliant?

Effective January 1st, 2012, all ANSI X12 electronic transactions will transition from the current 4010 format to the new and improved 5010 format. The new transaction standard, will affect not only the electronic submission of the 837 Claim format, but also all associated X12 transactions including the 270/271 Eligibility Inquiry and Response, the 276/277 Claim Status, and the 835 Remittance report. The Department of Health and Human Services is estimating that transition to the new 5010 format will save $12 billion from eliminating current manual processing of transactions.

The new 5010 format is also designed to support the use of ICD-10 which becomes mandatory On October 1, 2013. In addition, it is intended to promote pay-for-performance and to streamline reimbursement.

At TheraManager we are ready! Our software has been updated to conform to the new mandatory requirement and our support staff is ready to assist you in becoming compliant. Our customers can easily and seamlessly transition to the new 5010 format and submit/receive X12 transactions by using the latest version of TheraManager.

Additional Resources: coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code- set-standards/