Deadline for Enforcing HIPAA Version 5010 is Tomorrow!

The delay in enforcing the HIPAA version 5010 end on June 30, 2012 for all Medicare providers. Providers not compliant by June 30 will be penalized after the new requirement goes into effect on July 1. If your agency is not yet compliant, or are not sure if you are, you need to take immediate action to avoid disruption in payments.

If your agency is not yet compliant, start by contacting your software vendor to see what you need to do. If you are all set with your software, reach out to your clearinghouse. The good news is that most clearinghouses are now submitting using the 5010 format, but you should make sure your claims are uploading correctly and that they are fully 5010-compliant.

HCAF’s Executive Director Bobby Lolley recently met with Palmetto GBA leadership to get an update on the volume of claims being submitted on v4010 and the volume on v5010. The information provided below was reported for the week ending June 1, 2012. This information includes all Part A, Home Health, and Hospice providers.

Overall submissions

  • Total Claims submitted on v4010: 9.7%
  • Total Test Claims submitted on v5010: <.01%
  • Total Claims submitted on v5010:  90.2%

Submissions by clearinghouses or professional billers

  • Total Submitters submitting v4010: 56.8%
  • Total Submitters testing v5010: 2.6%
  • Total Submitters submitting v5010: 40.6%

Submissions by individual providers

  • Total providers submitting v4010: 54.9%
  • Total providers testing v5010: 2.3%
  • Total providers submitting v5010: 42.8%

Providers receiving claim remits

  • Total providers receiving v4010 remits: 78.9%
  • Total providers testing v5010 remits: 0%
  • Total providers receiving 5010 remits: 21.1%

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