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The New 5010 Enforcement Deadline: What Does the Delay Mean for Your Practice?

Last week, the Centers for Medicare & Medicaid Services (CMS) announced they would once again delay enforcement of HIPAA 5010 standards – this time until June 30, 2012. The decision came after an assessment of industry experiences with the 5010 transition, including a letter sent by the MGMA-ACMPE® to CMS requesting the enforcement deadline be extended because many of their association members were not ready. Among the reasons for their request was the fact that many practice administrators are still reporting significant delays in claim payments.

While not everyone has made the transition, CMS announced that many organizations – health plans, clearinghouses, providers and other technology vendors – have made significant progress towards transitioning to the new required HIPAA EDI standard. They anticipate that 98% of claims submitted by June 30th will be 5010 compliant.

There are many things your organization can do to ensure you are ready for the new deadline extension. If you’ve already made the 5010 transition, continue working to make sure you are aware of the 5010 requirements and have installed the necessary changes in your practice to meet these new requirements. In addition, you should be aware of where new denials and rejections are coming from, and how to correct and avoid many of the common problems other practices have seen.

If your organization is not in compliance, spend this time working diligently with vendors to learn what steps need to be taken so you meet the June 30th deadline. If you do not meet this deadline, your practice risks harsh penalties that could harm your organization’s bottom line – so be sure that your organization is fully prepared.

What do you think about the 5010 compliance deadline delay? Leave us a comment below to let us know.