5010: Important Changes are Coming

With the implementation of 5010, there will be a few changes in the way you send your electronic claim information. Understanding these changes and how they will affect your practice will prepare you for a smoother transition.  It is recommended that providers start testing for 5010 by January 1, 2011.  This recommendation is for all covered entities (including health care providers, health plans, and health care clearinghouses).

What’s next?

Now is the perfect time to contact your software vendor to determine if they will be providing any upgrades and if they will be testing on your behalf.   There will be practice management system changes that will be required for implementing the 5010 transactions. Depending on the contract with your software vendor, the system upgrades may be included in your current maintenance; however, some vendors may charge for those upgrades.

Questions you may want to ask your software vendor:

    * Can my current system accommodate both the data collection and transaction conduction for 5010?
    * Will you be upgrading my current system to accommodate the 5010 transactions?
    * Will there a charge for the upgrade?
    * When will the upgrades be available?
    * When will the installation to my system be completed?

If your software vendor will not be testing the new format for you, it will be necessary for you to submit test transactions directly to Gateway EDI.  This step will be required to help insure you are able to operate in production mode by the January 1, 2012 compliance date.