5010 Readiness

Our 5010 Facts page will be updated periodically to provide you with information on the implementation of 5010 HIPAA transaction standards and 5010 support.

Overview

On January 16, 2009, Health and Human Services (HHS) published two final rules to adopt updated HIPAA standards; these rules are available at the Federal Register.

For more detailed information, go to the HHS website.

HIPAA Compliance Dates:

January-December 2011; Partner testing and implementation of the new ASC X12 5010 transaction version.
Until December 31, 2011; The final rule allows dual use of either the previous version 4010A1, or the new version 5010.
January 1, 2012; Compliance date for 5010. Discontinue use of the previous ASC X12 version 4010A1. Only the updated 5010 ASC X12 version standard may be used.

Payers' Readiness

For more payer specific information, when available, please follow the links below:

Aetna Inc.
AvMed Health Plans
CIGNA
CIGNA Medicare of Arizona
CIGNA Select (Great-West)
CMO (The Care Management Company)
Community Care Inc. of WI
Community Health Network
Connecticare
Fidelis Care of New York
Healthpartners of Minnesota
Landmark Healthcare
MVP Health Care
Oxford Health Plans
River Valley
United Health Group
University Health Alliance

Testing

Post-n-Track is ready to accept 5010 test files using validation guidelines to validate for:

SNIP type 1 - EDI syntax integrity testing
SNIP type 2 - HIPAA syntactical requirement testing

Provider's can contact their account manager or support@post-n-track.com when ready to submit a 5010 test.

Payer Readiness

Post-n-Track will keep you updated as Payers become ready to begin testing 5010.

Please refer to the payer specific links in the box above on the right for more information. Visit this page regularly as those links are going to be updated when new information is made available.

Did you know?

You can visit http://www.wpc-edi.com to obtain 5010 companion guides and acknowledgment implementation guides in X12 version 5010.

You can also find reference tools that will show you the change description for the 4010 to 5010 versions.

Frequently Asked Questions

The following FAQs are provided to help you find the answers to some of the common questions we have received regarding 5010.

To view the answers to the questions listed below, simply click on the question.

Q1. What payer will be accepting 5010 first?

Q2. When will Post-n-Track be ready to test 5010 transactions?

Q3. What payers will be accepting both 4010 and 5010 transactions up until 12/31/2011?

Q4. How does Post-n-Track know if you are sending version 4010 or 5010?

Q5. When will payers be ready to begin testing and will there be a special Payer ID?

Q6. Do providers need to change their connectivity in any way?

Q7. Will Post-n-Track accept 4010 and 5010 at the same time before January 1, 2012 date?

Q8. Will 835s be returned in a 5010 format?

Q9. When will Post-n-Track be ready to accept 5010 for Real-time transactions?

Q10. Will Post-n-Track accept 4010 after the 5010 date of January 1, 2012?

Q11. Availability of 5010 payer companion guides.

Q12. What is the difference between a 999 and a 997PA?

Q13. What will the Real-time testing process be like?

Q14. Will Post-n-track have a testing portal?

Q15. Does Post-n-Track have plans to move anyone to production for 5010 (once testing is completed) prior to the 1/1/2012 compliance date? If so, once approved for 5010, could we still submit 4010A1?

Q16. Will Post-n-Track provide a 277CA?

Q17. Will test 835 files be available? Will these be based upon 5010 837 test data?

Q18. Will a new Trading Partner Agreement be required?

Q19. Will Post-n-Track return a test 5010 835 with the corresponding 4010 version?

Q20. Will Post-n-Track return a 999 if the payer does not?

Q21. Will Post-n-Track continue to provide the 997 file?

Q22. Will Post-n-Track support 4010A1 and 5010 835 transactions concurrently?

Q23. Will Post-n-Track provide a 999 during testing?

Q24. What will Post-n-Track provide in terms of claim test results?

Q25. Will the transmission process for 5010 files be the same as it is currently for 4010A1 production files?

Q26. When are remits available for downloads? Will 5010 impact this?

Q27. Will Post-n-Track provide a TA1 - Interchange Acknowledgement?

Q28. Will Post-n-Track require errata testing? If so, will Post-n-Track be testing errata changes separately?

Q29. What is Post-n-Track timeline for Errata testing?

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