HIPAA Simplifed Update for Channel Partners



We are pleased to announce that Emdeon has received notification that we have met the requirements of the EHNAC 5010 Readiness Assessment Program. Emdeon received a score of 100%, which further evidences Emdeon’s commitment to ensure compliance with HIPAA 5010.

In addition to this industry recognition, Emdeon continues to guide our customers successfully through the migration to the X12 5010 and NCPDP D.0 versions of the HIPAA transaction standards. We have updated our gap analysis documents to include the recent 5010 Errata changes and we have enhanced our 5010 systems and products to support the Errata versions HIPAA transactions. The Errata versions of the gap analysis documents are available at the HIPAA Simplified website under downloads.

We strive to provide you with the most updated and accurate information regarding our readiness for HIPAA 5010. Please see below answers to the most commonly asked questions regarding HIPAA 5010.

What is Emdeon’s current state and plans for HIPAA 5010 testing?
Emdeon is currently testing and implementing 5010 with submitters and payers. The late release of the Errata changes to the 5010 transaction standards further constricted the already narrow 5010 testing and conversion window. Nevertheless, as you can see in the list below, Emdeon has initiated submitter and payer testing on all 5010 transactions.

Errata Beta testing in process:
• 837 Professional claims
• 837 Institutional claims
• 837 Dental claims
• 835 ERAs
• 270/271 Eligibility verification

Emdeon is also testing the Final Rule version with submitters and payers for the HIPAA X12 transactions that were not included in the Errata revisions:
• 276/277 Claim Status
• 278 Referral/Authorization

How can my organization initiate testing with Emdeon?
Emdeon has created HIPAA 5010 conversion tools to help automate the conversion for your convenience. To begin this process, please initiate testing through your ON24/7 account. Please refer to the Submitter Claim Quick Reference Guide to guide you further. Detailed instructions are also available on Emdeon ON24/7.

What Emdeon solutions are impacted by 5010?
5010 impacts eligibility, claim, claim status and remittance transactions. The associated Emdeon solutions impacted by 5010 include our clearinghouse and others including:
• Emdeon Office
• Emdeon Payment Manager

How will my organization be notified of any product updates if required?
Emdeon is actively working on finalizing a global plan communications we will be providing to our clients throughout the year. In addition, fact sheets will soon be available and distributed for each product line.

What is the timeline(s) of events?
Emdeon is committed to fully support 5010 standards prior to the HIPAA 5010 compliance date. The precise dates on which Emdeon will support 5010 standards will vary based on the product, transaction, payer readiness and client readiness. Our goal is to have all Emdeon products modified and testing completed by the end of the year in order to be ready for the January 1, 2012 compliance date.

Where can I obtain additional information about HIPAA 5010?
Emdeon created a valuable web resource available to all industry stakeholders titled HIPAA Simplified, which may be found at www.hipaasimplified.com. HIPAA Simplified is a one-stop online resource that features gap analysis, business level documentation, webinars, timelines for the transition and testing information for our customers.

Thanks for trusting Emdeon as your source for HIPAA readiness. We are working diligently to deliver solutions that enable our customers to seamlessly meet these industry regulatory requirements.


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