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Tennessee Medicine: What Your Clearinghouse Should Be Doing to Prepare for 5010

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.