A few weeks ago, I spoke with the editor of ICD-10 Watch about how the transition to the new HIPAA 5010 electronic transaction standard went. Since the 5010 compliance deadline earlier this month, healthcare payers have had to learn to manage and respond to unexpected problems with medical claim rejections and denials. We discussed some of the specific problems that may be causing issues for practices, as well as the importance of tracking claims to ensure the reimbursement that practices receive is what they anticipated.

After our discussion, the editor wrote an article that summarized our discussion and the most common 5010-related problems practices are experiencing, along with the correction to these problems. You can read the full article here to learn more.

On January 1, 2012 HIPAA 5010 became the new required standard for electronic transactions. Are you wondering how to leverage the new 5010 standard effectively while ensuring your revenue cycle remains healthy?

Join us on Wednesday, February 15^th at 1:00 pm EST, for a complimentary webinar, 5010: The Good, the Bad, and the Ugly. Register Now.

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As an industry, the transition to HIPAA 5010 has been a learning opportunity – especially showing the benefits of planning and questioning a vendor’s capabilities early on. These lessons can be taken and applied to the next big transition – ICD-10, which will be the required coding set starting on October 1, 2013. Many people in the industry believe that there is plenty of time before the transition, and that they can start the transition process at a later time. However, now is the time for practices to start preparing for the coding change. So when I was recently given the opportunity to speak with a writer from For the Record about how the transition to ICD-10 would impact the industry and how practices should prepare, I was happy to share my thoughts.

At the start of this conversation, we focused on how this transition would impact everyone in the healthcare industry. It was the coders, though, that quickly became the focal point of our discussion. Specifically, we talked about the types of questions coders should be asking when preparing an ICD-10 transition plan. These questions include:

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Thank you to everyone who joined us on December 6 for our latest webinar, 5010 and ICD-10 – What You Must Know Now. During the one-hour event, industry expert, Ken Bradley, Vice President of Strategic Planning at Navicure, discussed where the industry is and where your practice should be with regards to 5010 and ICD-10; what to do if you have not begun preparing for 5010; how to fix the biggest problems practices are having with the 5010 requirements; and what steps you can take for ICD-10 revenue management success.

To learn more about how you can prepare for these two transitions, click here  to download the webinar recording.

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Medicare has announced that it plans to delay enforcement of the 5010 electronic transaction standards—but not the compliance date. (For those of you who lived through the initial HIPAA electronic transactions and code sets implementation in 2003, the announcement may feel like déjà vu.)

On November 17, the Centers for Medicare & Medicaid Services (CMS) Office of E-Health Standards and Services (OESS) issued a press release stating that it will not enforce compliance with the new 5010 transaction standards until March 31, 2012. However, the actual compliance date remains January 1, 2012.

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We’ve all seen—or asked—a question like this:

“I work for a provider who doesn’t submit claims electronically, and doesn’t plan to start because he’s retiring in a few years. How does 5010 affect providers who still submit claims on paper?”

Search for the answer and you’ll find a lot of confusion. Many, for example, are under the impression that after Jan. 1, 2012, all payers are obligated to ban paper claims and allow only electronic transactions. That’s not quite true.

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The HIPAA 5010 transition deadline is January 1, 2012. Is your practice prepared? If not, your bottom line will suffer.

Time is running out, but if you take the proper steps now, you can be ready. Since 5010 enables ICD-10, come January 1, the industry will have completed its first step towards ICD-10 compliance. However, ICD-10 will have a much bigger impact than 5010 and will require providers to re-think all processes. Practices must be preparing for ICD-10 now.

Join us on Tuesday, December 6 at 1:00 pm EST, for a free webinar: 5010 and ICD-10 – What You Must Know Now. Register Now.

During this hour, you’ll hear industry expert, Ken Bradley, Vice President of Strategic Planning at Navicure, discuss:

• Where the industry is and where your practice should be with regards to 5010 and ICD-10
• What to do if you have not begun preparing for 5010
• How to fix the biggest problems practices are having with the 5010 requirements
• What steps you can take for ICD-10 revenue management success

Make sure that your practice is prepared for these transitions.

 Participants can earn 1.0 Continuing Education Unit (CEU) from the American Academy of Professional Coders (AAPC) by attending.

Register Now.

By this point, everyone in the healthcare industry is aware that the deadline to transfer to HIPAA 5010 is January 1, 2012—which is only two away at this point!

Even though many practices and technology vendors have been preparing for this change for a year or two, many organizations still have questions about how 5010 is going to impact them. And they are also wondering what they should be doing right now to be sure their practice is completely prepared for HIPAA 5010.

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The process of preparing for and converting to ICD-10 has many moving parts. As practices, health plans, and other vendors work toward the October 1, 2013 deadline, I have been hearing lots of questions about how to successfully manage the conversion. Today, I will answer a few of the more commonly asked questions pertaining to the conversion.

At this point, what stage should our payers be in regarding ICD-10 implementation? Should they be ahead of us?

Since payers and vendors will lay the technology groundwork for what practices must do to successfully transition to ICD-10, they should be well into their ICD-10 work plan and ahead of where practices are today. Most large health plans are in the midst of readying themselves for the new code set and may be starting small tests. It is a good idea to reach out to your payers to understand their progress to date, as well as how you can work with them to make the ICD-10 transition as smooth as possible.

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With the transition to HIPAA Version 5010 quickly approaching, practices must verify that their health information technology (HIT) vendors will be ready for the change. If not, practices risk significant disruptions to cash flow on the January 1, 2012 implementation date. The conversion will affect most major healthcare transactions and nearly all technology, practices and HIT vendors—all who need to make sure they are fully prepared. While every vendor must take specific steps to get ready, clearinghouses bear the rather unique burden of ensuring that claims will cross smoothly between payers and practices.

For practices, it is important to begin communicating now—especially with clearinghouses—to determine whether testing is necessary and, if so, what the 5010 testing schedules are. Past experience with conversions to the current 4010A1 standard and the National Provider Identifier (NPI) suggests the 5010 transition will be the smoothest and least risky if staggered by payer over the course of 2011. Practices can assess progress on the part of their clearinghouses by watching for a few preparation milestones.

Click here to read the entire article I wrote for Tennessee Medicine and learn which milestones you should be looking for from your clearinghouse.