RemitDATA is responding to 5010
Currently, RemitDATA provides analytics from the ASC X12 835 data file; we do not create or directly exchange files with payers or clearinghouses. The changes required for Version 5010 transaction compliance are primarily the responsibility of your practice management vendor, payers and clearinghouses, however RemitDATA will accommodate the information exchanged from other healthcare information technology (HIT) vendors. RemitDATA is also working with our partners, including Allscripts, OptumInsight, and NextGen Healthcare to ensure a smooth transition to the Version 5010 and ICD-10 standards.
To proactively prepare, RemitDATA has begun work to implement Version 5010 into all of our solutions. Through our development efforts and working closely with our customers and partners to conduct comprehensive quality assurance tests, RemitDATA will complete testing and implementation of the Version 5010 standards prior to the CMS deadline of January 1, 2012.
5010 Benefits
Implementation of the ANSI X12 Version 5010 standard promises to bring clarity and consistency to claims transactions by increasing transaction uniformity and streamlining reimbursement transactions when compared to the Version 4010 standards. 5010 transactions will contain more data than the 4010 transactions and will facilitate more accurate coding, billing and reimbursement. There are over 1300 changes found in the Version 5010 standard, many of which address deficiencies found in the 4010 standard. These changes include:
- Removal of workarounds and coding addenda, which resulted in use of different standards for each payer
- Standardization of payer implementation guides to present information consistently across all transactions types
- Reformat of reporting instructions for “situational data” to define when to send specific data elements
- Addition of an embedded link to payer URLs within the 835 transaction, making it easy to find payer websites to research and clarify payment adjustments and denial codes
- Removal of data elements deemed no longer needed
- Separation of data fields accommodating multiple types of data; resulting in reporting of distinct data in each field
- Provide framework to allow reporting of ICD-10 diagnosis and procedure codes in a common, detailed format across all transaction types. ICD-10 procedure codes become effective October 1, 2013.
5010 Deadlines
There are two deadlines that must be met during the mandated update:
Level I compliance - December 31, 2010
Level II compliance - December 31, 2011
All covered entities must be fully compliant and ready for production by January 1, 2012.
- Level I compliance - "A covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing."
- Level II compliance - "A covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards."