5010 Deadline Fast Approaching

Many people view the 5010 deadline of 1/1/12 as the time when you need to switch from 4010 to 5010 HIPAA transactions. This is not exactly true.  This deadline reflects when 4010 transactions will no longer be accepted by CMS and other payers.  The reality is that CMS expects providers to be sending 5010 transactions BEFORE this deadline.  In order to accomplish this:

  • You must have the ability to create valid 5010 transactions
  • You must have passed testing with your payers
  • You must be placed in production status  

Once this occurs, you can begin sending your claims in 5010 format at any time. 

This should occur well ahead of the deadline to completely eliminate any potential problems that you may have in your system in creating these files properly, reading the associated response files, and most importantly, getting paid.

5010 testing – a survival guide

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