What is the 5010 ANSI standard?

HIPAA has required the U.S. Department of Health and Human Services (HHS) to adopt new standards for claims, claim status, remittance advice and online eligibility. Accordingly, the Centers for Medicare & Medicaid Services (CMS) has mandated adoption of the transaction standard X12 version 5010. This new standard supports the new ICD-10-CM codes.

How does the 5010 ANSI affect most TotalMD Customers (customers who send e-claims to clearinghouses)?

Through December 31, 2011 all TotalMD systems are in full compliance with the CMS’s specifications. Beginning January 1, 2012, clearinghouses and payers are required to use the new mandated standard X12 version 5010 format. Most clearinghouses, including Gateway EDI, APEX EDI, and Availity will be compliant before this date.

How does the 5010 ANSI affect TotalMD’s Direct ANSI Module Customers?

Customers who use one of the TotalMD direct ANSI e-claim modules will be required to upgrade their module(s) before December 31, 2011 to bring it into compliancy with the new e-claim standard.

What you need to know

Our TotalMD development team has been extremely proactive with the ANSI 5010 specifications and is finalizing software modification well in advance of the HIPAA deadlines. If you are a current TotalMD ANSI e-claim customer and are interested in beta testing our fully compliant release, please contact our ANSI 5010 beta coordinator, Alaric Fox, at (800) 613-7597 x 210

For additional information, see these sites

http://www.gatewayedi.com/5010
www.apexedi.com/support/5010-compliance
www.availity.com/about-availity/what-is-availity/regulatory-compliance/5010-and-ICD-10
www.cms.hhs.gov/ElectronicBillingEDITrans/18_5010D0.asp
www.cms.gov/MLNMattersArticles/downloads/SE0832.pdf