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Healthcare: HIPAA 5010 Systems Impact

Healthcare: HIPAA 5010 Systems Impact

Abstract

The Center for Medicaid and Medicare Services (CMS) requires the health plans to adopt modifications to the HIPAA electronic transaction standards published on Jan 16, 2009, for exchanging healthcare specific administrative and financial transactions. The current version adopted by the industry is ASC X12 Version 4010A1 for healthcare transactions and NCPDP Version 5.1 for pharmacy transactions. Health plans are now required to implement recently published HIPAA version 5010 and NCPDP D.0 standards by Jan 1, 2012.

Excerpts from the Paper

5010 changes have impact on policies, processes and applications across a health plan. HCL’s understanding of the health plan’s IT landscape facilitates the identification of impact of 5010/ D.0. Impact analysis output details out the modifications required for seamless implementation of changes in systems, processes and applications. This ensures a smooth transition to HIPAA 5010/D.0 with minimal disruption. HCL has done the initial assessment for each HIPAA transaction type for identifying the impacted business areas and entities across health plans.

 

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