5010 is the next version of the HIPAA electronic transaction standards. If you submit electronic healthcare transactions, such as filing a claim, checking a patient's eligibility, or receiving remittance advice you should be aware of the 5010 update to the HIPAA electronic transaction standards.
Several benchmarks must be met along the way towards being 5010 compliant. Apex EDI is working diligently to make sure our clients and partners are well prepared and covered as the transition to 5010 approaches. Apex EDI is dedicated to making the transition to 5010 as easy as possible. We are building the technology into our systems that will allow you to decide when you want to convert to 5010 and to make sure you continue to get paid no matter where your practice is in the process.
Below is a schedule of 5010 benchmarks and deadlines.
5010 Schedule and Deadlines
January 1, 2010
- Payers and providers should begin internal testing of Version 5010 standards for electronic claims
December 31, 2010
- Internal testing of Version 5010 must be complete to achieve Level I Version 5010 compliance
January 1, 2011
- Payers and providers should begin external testing of Version 5010 for electronic claims
- CMS begins accepting Version 5010 claims
- Version 4010 claims continue to be accepted
APRIL 1, 2011
- Apex EDI begins testing
MAY 1, 2011
- Apex EDI will begin Preliminary testing with trading partners
JUNE 1, 2011
- Apex EDI will begin 837P testing with medical trading partners
JULY 1, 2011
- Apex EDI will begin 837D testing with dental trading partners
AUGUST 1, 2011
- Apex EDI will begin 999, 277CA, 835 testing with trading partners
SEPTEMBER 1, 2011
- Apex EDI will begin 270/271 testing with trading partners
November 1, 2011
- Apex EDI will start Migrating Data to 5010 Tables
December 31, 2011
- Apex EDI will complete the conversion to accepting 5010 data
January 1, 2012
- All electronic claims must use Version 5010
- Version 4010 claims are no longer accepted
October 1, 2013
- Claims for services provided on or after this date must use ICD-10 codes for medical diagnosis and inpatient procedures
- CPT codes will continue to be used for outpatient services
If you would like help preparing for the 5010 transition, request the Apex EDI 5010 checklist here.
About Apex EDI
Apex EDI is a leading healthcare claims clearinghouse for medical and dental professionals. Apex EDI serves thousands of physicians, dentists, and other medical providers nationwide with its Apex OneTouch® solution. The OneTouch® solution is a Web-based electronic claims reimbursement system that increases productivity and profitability while facilitating fast payment of insurance claims and providing additional reporting and analysis. Founded in 1995, Apex EDI is based in American Fork, Utah.