5010 Preparedness
HealthTec Software is aware many of you have received notices from payers and different associations to
make sure your practice is prepared for “5010.”
“5010” specifically relates to the new electronic claim format, which will be implemented on January 1,
2012 and the move from ICD-9 to ICD-10 codes, which is scheduled to be implemented on October 1,
2013.
The first major step, which is scheduled to occur January 1, 2012, is the change from the current 4010
electronic claim to the 5010 format. The new format includes over 800 new data elements and will be able
to accommodate the new ICD-10 codes. Many of these new data elements though are situational and
will not impact most claims. These changes are being added to address issues that some providers had
submitting the current 4010 format.
We are aware that you are being asked to begin testing the new format and to contact your software
vendor.
First, HealthTec in conjunction with our clearinghouse partners has been testing for months. Unless you
submit direct to a payer, you DO NOT need to test. If you submit via a clearinghouse, the
clearinghouse is the submitter. We have verified that our partner clearinghouses (HT Claim Services,
ClaimRemedi, Availity, ClaimLogic and Health-e-Web (formerly ET&T)) have tested and are ready for the implementation of
5010.
If you are using a NON-supported clearinghouse to submit claim electronically, you will want to contact
the clearinghouse and determine if they can “cross-walk” your current 4010 format to the new 5010
format. HealthTec DOES NOT support direct submission to payers.
Despite the dire warnings about the “5010” deadline, many practices today are still submitting print image
or NSF formats that are translated into the 4010 format upon receipt.
We have tested our current HTPM system and our new Trilogy application with our supported
clearinghouse destinations. If you are on a Support and Update Subscription and use one of our
Supported Clearinghouse Partners and it is determined any updates or patches are required you will
receive these prior to the January 1st implementation deadline.
If you are on an earlier version of software other than HTPM 5b or HealthTec Trilogy and you are not
using a supported destination you may want to consider changing your clearinghouse now. HealthTec
offers a variety of services including a free option. You will also need to update your software to the
5b version or Trilogy.