| PHYSICIANS: Get 5010 Ready |
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HIPAA 5010 transactions will affect almost every aspect of a practice’s reimbursement and revenue stream. In order to achieve compliance, physicians will need to update software systems and adjust for changes in workflow. It may seem daunting, but the effort will pay off in improved business processes and a shorter revenue cycle.
Business Issues
Physicians face many challenges with the new 5010 transaction standards:
- Existing practice management and EDI systems may need to be upgraded to comply with the new transaction standards
- To ensure compliance, they will need to work with their claims clearinghouses and review contracts
- 5010 requires new translation, mapping, and data fields
- Implementation guides are no longer free
- Certain business practices will change and practices need to accommodate for training and decrease in staff productivity during transition
- Must adjust for the data reporting changes for the various transactions
- Workflow processes may change in order to collect appropriate data when the transactions go live
- Staff will need training in order to submit, receive, interpret, and respond appropriately using 5010 transactions
Critical questions every executive should be asking:
- How do I perform an inventory of existing systems to determine which will be affected by the change?
- What are my vendors’ upgrade plans?
- Will my business partners and clearinghouses be ready by the deadline?
- Will my billing service or clearinghouse increase their fees for the 5010 transactions?
- When can I send test transactions to my billing service or clearinghouse to make sure the system will work?
- Will I need to re-negotiate my provider contract or EDI agreement based on 5010 x12 transactions?
- How can I plan ahead for changes in work flow and staff training to minimize disruption?
- What is the cost of training resources?
- How do I know which transactions to test and will we conduct the testing with test data or live production data?
Why should you consider Ingenix as a 5010 partner?
Our comprehensive solutions can help your organization use the 5010 transition as a springboard to improved operating effectiveness:
- Ingenix Claredi® Classic—HIPAA 5010 and 4010A1 transaction testing and certification
- Transaction Exchange—National health care clearinghouse for providers and payers
- Consulting Services—Wide-ranging expertise to help organizations assess, plan, and implement HIPAA 5010, ICD-10, and other solutions
- Ingenix Learning and Development Services-Online or onsite classes to educate functional and technical staff on HIPAA 5010
GET STARTED NOW.
Contact Ingenix to discuss your 5010 preparation.
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