Late for HIPAA 5010 Compliance? There May be Hope

The Jan. 1, 2012, compliance deadline for the HIPAA 5010 transactions is coming fast but there’s still a lot of work that can be done during the next few months, says Rob Tennant, senior policy advisor for government affairs at the Medical Group Management Association.


The Jan. 1, 2012, compliance deadline for the HIPAA 5010 transactions is coming fast but there's still a lot of work that can be done during the next few months, says Rob Tennant, senior policy advisor for government affairs at the Medical Group Management Association.

At a session during the MGMA 2011 Annual Conference, Oct. 23-26 in Las Vegas, Tennant will walk through current 5010 readiness, steps practices should take now if not prepared--like contracting with a claims clearinghouse if they haven't already--and the possibility of some flexibility being attached to the compliance date.

Tennant doesn't see the data being extended, but he does hope the government--and other payers--will show some flexibility. For instance, if a claim has enough data to be adjudicated, he hopes the claim isn't rejected because it doesn't have a piece of meaningless data. Tennant is cautiously optimistic that such flexibility will be shown. "It's in nobody's interest to have nationwide claims disruption."

But physician practices shouldn't be counting on an extension or flexibility, he contends. If a practice won't be ready by January, it needs to start padding its cash reserves and getting a line of credit to meet financial responsibilities if some or all of its claims are getting rejected.

In addition to the 5010 migration, there are other looming initiatives that will have a large affect on financial and administrative transactions processing. Tennant will walk through such issues as ICD-10, health plan identifiers, claims attachments and operating rules. "If I can do one thing, it's to give attendees a roadmap," he says. "There's a lot of things coming."

Session C12: "ICD-10 and New HIPAA 5010 Transaction Standards," is scheduled at 3:45 p.m. on Monday, Oct. 24. More information is available at mgma.com.

 

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