You may be wondering, just what exactly is this 5010 thing that you have been hearing about? Many of you might be experiencing denials of claims in your office and it could be coming from the new 5010 Standard.
The 5010 Standard is this HIPAA rule that changes how the electronic claims are filed with the clearing houses and with the insurance companies.
Basically the new 5010 standard changes how the information flows, and changes the format of the information.
So, everywhere that information goes; whether it be a clearing house or a third party payer, everything in the system is changed and if you have just one mistake, one small error in the system, you will experience some denials.
When it comes to electronic software some of you may have software that is based on the HIPAA 4010 Standard.
If that is the case and your software has not been upgraded to the 5010 Standard and you do not have a clearing house that is able to translate a 4010 to a 5010 then you will start to experience some denials.
The 5010 standard was initially supposed to go into effect on January 1st, 2012, but the federal government kept delaying that date. First to March 31st, then to June 30th, and it could be delayed again.
Yet all across the country we are seeing different groups deny claims that are not based on the 5010 Standard. So it’s important for you to check your software and with your vendor to be sure that you are on the 5010 Standard to prevent denials.
Be sure that you have a clear deployment of the software based on the 5010 Standard and you’ll be in great shape to avoid a bunch of denied claims.
To view this blog as a video click this link – Chiropractic HIPAA Compliance 5010 video.
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