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 4010A1, 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. After January 1, 2012, version 4010A1 will no longer be accepted.
While the timeline to adopt the new version is distant, providers and billing vendors will need to make significant system changes to prepare for this mandatory conversion.
IBC has prepared a list of Frequently Asked Questions (FAQ) surrounding the conversion to 5010. Visit our website at www.ibx.com/icd10 to view the 5010 FAQ. IBC will continue to communicate to providers during the ongoing transition to 5010. Please continue to check Partners in Health Update, the NaviNet® web portal, and www.ibx.com/providers for information regarding the conversion to 5010.