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HIPAA 5010 Changes

HIPAA 5010 Changes

Abstract

Key objective of the newer protocol is to improve the functionality and address the concerns that have been identified which were not thoroughly analyzed during 4010 adoption. The implementation of 5010 presents substantial changes in the content of the data involved in outgoing and incoming transactions. Thus this would require all the health plans to upgrade their business policies, processes and systems for accommodating 5010 changes. A closer evaluation of the standard indicates that this compliance is NOT just about transactions, codes, data elements, field length; it is about tactful Change Management along with Business and Clinical processes reengineering.

Excerpts from the Paper
The process is initiated by conducting the AS-IS study of policies, processes and IT assets tounderstand the enterprise landscape. Based upon the transaction changes all the affected entities are identified and the associated risk is calculated. Considering the varied level of impacts of the identified risk areas, a contingency plan is designed. 

HCL uses its proprietary Enterprise Discovery Framework to facilitate enterprise discovery and consequently mapping of business processes to IT applications. It forms the basis for any further phases of the upgrade methodology. As per the assessment done by HCL, there are more than 3,500 changes over previous 4010A1 transaction standard. These changes have a significant impact on health plans across policies, processes, systems and people. 

 

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