The Health Insurance Portability and Accountability Act (HIPAA) requires providers to adopt specific standards for electronic health care transactions (e.g., claims, eligibility inquiries, claims status requests, and responses). The current version is 4010A, but federal regulation mandates that this version be replaced with the new 5010 version by January 1, 2012. Beginning January 1, 2012, providers and vendors must use the HIPAA 5010 electronic format to submit information to IBC and other payers.
There will be a transitional period of time when IBC will accept claims in both 4010A and 5010 formats. As stated in our HIPAA 5010 Frequently Asked Questions (FAQ) posted on www.ibx.com/icd10, our initial target date for being dually compliant (accepting both 4010A and 5010 claims) was August 1, 2011. Please note our new target date is August 22, 2011. Therefore, from August 22, 2011, through December 31, 2011, you can submit claims using either version 4010A or 5010. Starting January 1, 2012, version 4010A will no longer be accepted. We have updated our FAQ with the new go-live date. Visit www.ibx.com/icd10 to view the HIPAA 5010 FAQ.
IBC will continue to communicate to providers during the ongoing transition to 5010. Please check Partners in Health Update, the NaviNet® web portal, and www.ibx.com/providers periodically for information regarding the conversion to 5010.