HIPAA Update for Channel Partners

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 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 while already in production with some payers and submitters. 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 testing/production in process:
• 837 Professional claims
• 837 Institutional claims
• 837 Dental claims
• 835 ERAs
• 270/271 Eligibility verification

Emdeon is also testing and implementing 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 Emdeon 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.

How will my organization be notified of any product updates if required?
Emdeon has created a global communications plan for our clients. In addition, HIPAA 5010 Product fact sheets are available and being distributed for each product line. Remember to frequently visit Emdeon’s hipaasimplified.com website which has been recently updated and reorganized to contain new valuable content like product fact sheets and product specific testing information.

What is the timeline(s) of events?
The compliance date of HIPAA 5010 conversion is January 1st, 2012*. All Emdeon products and services have been remediated for 5010; we are in testing phase with many submitters and payers while already in production with some submitters and payers.

Is 5010 delayed until March 2012?
No, the compliance date for 5010 standards remains January 1, 2012, however on November 17th , 2011, CMS announced that the Office of E-Health Standards and Services (OESS) would not initiate enforcement action until March 31, 2012. Emdeon strongly encourages its clients to meet the January 1, 2012 compliance deadline if possible. Customers should not view this announcement as a 90 day extension of the compliance date and should continue testing earnestly with their trading partners to meet the end of the year deadline.
http://www.cms.gov/ICD10/Downloads/CMSStatement5010EnforcementDiscretion111711.pdf

Did Emdeon participate in the CMS National version 5010 Testing Days?
Yes, Emdeon did participate in the CMS National version 5010 day on June 14th and also in the subsequent testing week (August 22nd to August 26th). Emdeon sent test files to all Medicare Administrative Contractors (MACs) during both these testing periods.

How can I obtain additional information about HIPAA 5010?
Emdeon has 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.

*The compliance date for 5010 standards remains January 1, 2012, however on November 17th, 2011; CMS announced that the Office of E-Health Standards and Services (OESS) would not initiate enforcement action until March 31, 2012. Emdeon strongly encourages its clients to meet the January 1, 2012 compliance deadline if possible.

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