HIPAA Simplified
As a trusted leader, Emdeon has prepared this website as a resource to help guide the healthcare industry through the transition to HIPAA X12 Version 5010, NCPDP D.0, and ICD-10.
To help guide our clients, as a starting point, we have provided the following chart that combines the various timelines into one, showcasing the progression of HIPAA and other regulatory initiatives.
Simply click on the image below to enlarge.
This transition to X12 Version 5010 and NCPDP D.0 will affect many segments and includes many transaction sets for physicians, hospitals, payers, pharmacies, dentists, and channel partners. We will also be publishing a section dedicated to Acknowledgments. The transaction sets include:
- 270/271 - Health Care Eligibility Benefit Inquiry and Response
- 276/277 - Health Care Claim Status Request and Response
- 278 - Health Care Services - Request for Review and Response; Health Care Services Notification and Acknowledgment
- 835 - Health Care Claim Payment/Advice
- 837 - Health Care Claim: Professional , Institutional, and Dental, including coordination of benefits (COB) and subrogation claims
- NCPDP D.0 - Pharmacy Claim
As a service to you, our clients, we have developed HIPAA Simplified as a one-stop-shop for our technical gap analysis documentation, simplified business-level topics, trading partner transition strategy information, frequently asked questions (FAQs), testing tools, etc.
Additionally, we have created pages specific for each of these business segments. From the navigation menu on the left, simply click on the page that is applicable to your business and browse the provided resources.
Make sure to bookmark both HIPAA Simplified and your segment page - you'll want to check back often, since we'll be updating this site with new information as we approach the hard deadlines for the transition.
In order to better facilitate joint implementation planning, Emdeon is committed to understanding your HIPAA plans and timeline. To this end, we would appreciate your sharing any issues, ideas, challenges, or concerns with your knowledgeable Emdeon Account Representative, who will help ensure that we are on the same page as we transition to X12 Version 5010, NCPDP D.0, and ICD-10 together.
Thanks for trusting Emdeon as your source for HIPAA readiness. Just as with X12 Version 4010 and with the National Provider Identifier (NPI), we are working diligently to deliver solutions that enable our customers to seamlessly meet the new requirements for X12 Version 5010, NCPDP D.0, and ICD-10.
Please note that this information is provided by Emdeon for education and awareness use only. While Emdeon believes that all the information on this website is correct as of February, 2010, Emdeon does not warrant the accuracy, completeness or fitness for any particular purpose of this information. All use is at the reader's own risk. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Emdeon.
These documents should be used along with the X12 5010 TR3 Documents. To obtain your copy of the TR3 visit the X12 Web Site at: http://www.X12.org and follow the link to the X12 Store.
Payer
As part of Emdeon's commitment to guiding our clients through the transition to HIPAA X12 Version 5010 standards, we have completed a thorough gap analysis between versions 4010A and 5010, which we are using to enhance all of our systems and products to support the modified HIPAA transaction sets.
Our goal is to be ready to pilot for payer clients in the first half of 2010. We will begin with professional and institutional claims in April of 2010, which represents a pace well-ahead of the recommendation published by the Department of Health and Human Services, stating that trading partner testing should begin by January of 2011. We are also on schedule to be well-ahead of the January 2012 compliance date for the mandatory transition to HIPAA X12 Version 5010 standards.
As a starting point, we have included a high-level FAQ to explain the most commonly discussed topics and questions pertaining to HIPAA X12 Version 5010 standards. Simply click below to access the FAQ page:
Provided below are downloadable documents that explain the changes between versions 4010A and 5010 in easy-to-understand, business-level language for professional and institutional claims. We have also published a guide that outlines the common issues and challenges for 837 claims that covered entities will face in transitioning to HIPAA 5010.
We have also provided in-depth technical gap analyses below:
Emdeon recommends that payers return acknowledgement transactions:
We will soon be publishing additional resources for payers, such as documentation about the issues and challenges that providers and payers will likely face for each of these transaction types. We will also be providing detailed information about how to test with the HIPAA X12 Version 5010 transactions with Emdeon.
Emdeon will provide guidance for ICD-10 at a later date.
Please note that this information is provided by Emdeon for education and awareness use only. While Emdeon believes that all the information on this website is correct as of February, 2010, Emdeon does not warrant the accuracy, completeness or fitness for any particular purpose of this information. All use is at the reader's own risk. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Emdeon.
These documents should be used along with the X12 5010 TR3 Documents. To obtain your copy of the TR3 visit the X12 Web Site at: http://www.X12.org and follow the link to the X12 Store.
Physician
As part of Emdeon's commitment to guiding our clients through the transition to HIPAA X12 Version 5010 standards, we have completed a thorough gap analysis between versions 4010A and 5010, which we are using to enhance all of our systems and products to support the modified HIPAA transaction sets.
Our goal is to be ready to pilot for physician clients in the first half of 2010. We will begin with professional and institutional claims in April of 2010, which represents a pace well-ahead of the recommendation published by the Department of Health and Human Services, stating that trading partner testing should begin by January of 2011. We are also on schedule to be well-ahead of the January 2012 compliance date for the mandatory transition to HIPAA X12 Version 5010 standards.
As a starting point, we have included a high-level FAQ to explain the most commonly discussed topics and questions pertaining to HIPAA X12 Version 5010 standards. Simply click below to access the FAQ page:
Provided below are downloadable documents that explain the changes between versions 4010A and 5010 in easy-to-understand, business-level language for professional and institutional claims. We have also published a guide that outlines the common issues and challenges for 837 claims that covered entities will face in transitioning to HIPAA 5010.
We have also provided in-depth technical gap analyses below:
Emdeon recommends that submitters accept acknowledgement transaction responses:
We will soon be publishing additional resources for physicians, such as documentation about the issues and challenges that physicians will likely face for each of these transaction types. We will also be providing detailed information about how to test with the HIPAA X12 Version 5010 transactions with Emdeon.
Emdeon will provide guidance for ICD-10 at a later date.
Please note that this information is provided by Emdeon for education and awareness use only. While Emdeon believes that all the information on this website is correct as of February, 2010, Emdeon does not warrant the accuracy, completeness or fitness for any particular purpose of this information. All use is at the reader's own risk. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Emdeon.
These documents should be used along with the X12 5010 TR3 Documents. To obtain your copy of the TR3 visit the X12 Web Site at: http://www.X12.org and follow the link to the X12 Store.
Pharmacy
As part of Emdeon's commitment to guiding our clients through the transition to HIPAA NCPDP Version D.0 standard, we have completed a thorough gap analysis between versions 5.1 and D.0 and ASC X12 4010 to 5010, which we are using to enhance all of our systems and products to support the modified HIPAA transaction sets.
Our goal is to be ready to pilot for pharmacy clients in the first half of 2010, which represents a pace well-ahead of the recommendation published by NCPDP and Department of Health and Human Services, stating that trading partner testing should begin by January of 2011. We are also on schedule to be well-ahead of the January 2012 compliance date for the mandatory transition to HIPAA NCPDP Version D.0 and ASC X12 5010 standards. In addition, we maintain an active role in the pharmacy community, including NCPDP workgroups that are focused on this important issue. As appropriate, we will work with our pharmacy clients and business partners regarding testing and other implementation needs.
As a starting point, we have included a high-level FAQ to explain the most commonly discussed topics and questions pertaining to HIPAA NCPDP D.0 and ASC X12 Version 5010 standards. Simply click below to access the FAQ page:
Emdeon will provide guidance for ICD-10 and testing at a later date.
Please note that this information is provided by Emdeon for education and awareness use only. While Emdeon believes that all the information on this website is correct as of February, 2010, Emdeon does not warrant the accuracy, completeness or fitness for any particular purpose of this information. All use is at the reader's own risk. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Emdeon.
These documents should be used along with the X12 5010 TR3 Documents. To obtain your copy of the TR3 visit the X12 Web Site at: http://www.X12.org and follow the link to the X12 Store.
Hospital
As part of Emdeon's commitment to guiding our clients through the transition to HIPAA X12 Version 5010 standards, we have completed a thorough gap analysis between versions 4010A and 5010, which we are using to enhance all of our systems and products to support the modified HIPAA transaction sets.
Our goal is to be ready to pilot for hospital clients in the first half of 2010. We will begin with professional and institutional claims in April of 2010, which represents a pace well-ahead of the recommendation published by the Department of Health and Human Services, stating that trading partner testing should begin by January of 2011. We are also on schedule to be well-ahead of the January 2012 compliance date for the mandatory transition to HIPAA X12 Version 5010 standards.
As a starting point, we have included a high-level FAQ to explain the most commonly discussed topics and questions pertaining to HIPAA X12 Version 5010 standards. Simply click below to access the FAQ page:
Provided below are downloadable documents that explain the changes between versions 4010A and 5010 in easy-to-understand, business-level language for professional and institutional claims. We have also published a guide that outlines the common issues and challenges for 837 claims that covered entities will face in transitioning to HIPAA 5010.
We have also provided in-depth technical gap analyses below:
Emdeon recommends that submitters accept acknowledgement transaction responses:
We will soon be publishing additional resources for hospitals, such as documentation about the issues and challenges that hospitals will likely face for each of these transaction types. We will also be providing detailed information about how to test with the HIPAA X12 Version 5010 transactions with Emdeon.
Emdeon will provide guidance for ICD-10 at a later date.
Please note that this information is provided by Emdeon for education and awareness use only. While Emdeon believes that all the information on this website is correct as of February, 2010, Emdeon does not warrant the accuracy, completeness or fitness for any particular purpose of this information. All use is at the reader's own risk. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Emdeon.
These documents should be used along with the X12 5010 TR3 Documents. To obtain your copy of the TR3 visit the X12 Web Site at: http://www.X12.org and follow the link to the X12 Store.
Dental
As part of Emdeon's commitment to guiding our clients through the transition to HIPAA X12 Version 5010 standards, we have completed a thorough gap analysis between versions 4010A and 5010, which we are using to enhance all of our systems and products to support the modified HIPAA transaction sets.
Our goal is to be ready to pilot for dental clients in the first half of 2010. We will begin with claims in April of 2010, which represents a pace well-ahead of the recommendation published by the Department of Health and Human Services, stating that trading partner testing should begin by January of 2011. We are also on schedule to be well-ahead of the January 2012 compliance date for the mandatory transition to HIPAA X12 Version 5010 standards.
As a starting point, we have included a high-level FAQ to explain the most commonly discussed topics and questions pertaining to HIPAA X12 Version 5010 standards. Simply click below to access the FAQ page:
Additionally, below you can find a full gap analysis that outlines the changes from HIPAA 4010A and 5010, and a simplified gap analysis that explain the changes between versions 4010A and 5010 in easy-to-understand, business-level language:
Emdeon recommends that submitters accept acknowledgement transaction responses:
Emdeon will soon be publishing detailed information about how to test with the HIPAA X12 Version 5010 transactions with Emdeon. We will provide guidance for ICD-10 and testing at a later date.
Please note that this information is provided by Emdeon for education and awareness use only. While Emdeon believes that all the information on this website is correct as of February, 2010, Emdeon does not warrant the accuracy, completeness or fitness for any particular purpose of this information. All use is at the reader's own risk. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Emdeon.
These documents should be used along with the X12 5010 TR3 Documents. To obtain your copy of the TR3 visit the X12 Web Site at: http://www.X12.org and follow the link to the X12 Store.
Channel Partner
As part of Emdeon's commitment to guiding our clients through the transition to HIPAA X12 Version 5010 standards, we have completed a thorough gap analysis between versions 4010A and 5010, which we are using to enhance all of our systems and products to support the modified HIPAA transaction sets.
Our goal is to be ready to pilot for our clients in the first half of 2010. We will begin with professional and institutional claims in April of 2010, which represents a pace well-ahead of the recommendation published by the Department of Health and Human Services, stating that trading partner testing should begin by January of 2011. We are also on schedule to be well-ahead of the January 2012 compliance date for the mandatory transition to HIPAA X12 Version 5010 standards.
The transition to HIPAA X12 Version 5010 will require that channel partners modify the data they send and receive with their clients that are covered entities. Such modifications may impact the software and operational procedures currently utilized for providers, payers, and clearinghouses.
This site is here to help our channel partner clients that will need to know this required information. Furthermore, we understand many of the issues you will face with the impending transition:
- Because of deployment requirements necessary to upgrade software to meet HIPAA X12 Version 5010 standards for an extensive customer base, we believe you should test and validate all HIPAA transactions during the second and third quarter of 2010;
- We want to ensure that Emdeon is ready internally within this same timeframe for all transactions that our channel partners support; and
- Channel partner clients are concerned that some payers may not be on the same readiness timeframe as our other clients.
Because we understand that our channel partner clients work closely with providers and payers, we have included a high-level FAQ to explain the most commonly discussed topics and questions pertaining to HIPAA X12 Version 5010 standards. Simply click below to access the FAQ page.
Provided below are downloadable documents that explain the changes between versions 4010A and 5010 in easy-to-understand, business-level language for professional and institutional claims
:
We have also provided in-depth technical gap analyses below :
Emdeon recommends that submitters accept acknowledgement transaction responses:
We will soon be publishing additional resources for our channel partner clients, such as documentation about the issues and challenges that providers and payers will likely face for each of these transaction types. We will also be providing detailed information about how to test with the HIPAA X12 Version 5010 transactions with Emdeon.
Emdeon will provide guidance for ICD-10 at a later date.
Please note that this information is provided by Emdeon for education and awareness use only. While Emdeon believes that all the information on this website is correct as of February, 2010, Emdeon does not warrant the accuracy, completeness or fitness for any particular purpose of this information. All use is at the reader's own risk. The information provided here is for reference use only and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Emdeon.
These documents should be used along with the X12 5010 TR3 Documents. To obtain your copy of the TR3 visit the X12 Web Site at: http://www.X12.org and follow the link to the X12 Store.
