Timeline for the EDI Implementation of Version 005010

January 14, 2011

Timeline for the EDI Implementation of Version 005010

On January 16, 2009, The Department of Health and Human Services published a final rule adopting X12 Version 005010 and NCPDP Version D.0. for HIPAA (Health Insurance Portability and Accountability Act) transactions.

The compliance dates for Version 005010 and Version D.0 for all covered entities, is January 1, 2012.

Follow these timelines as you work with your software vendor, billing service and Trading Partners to ensure a successful transition to the 005010 version.

Some Payers are already accepting and returning Version 005010 Claim Transactions.

1EDISource is helping our Health Care clients to be compliant and get the work done in time for the deadline. EDI/HQ™ is ready for 005010.

If your Payers are requesting a new 005010 Certification, new enrollment or authorization form to sign up for a new 005010 Trading Partner or to update your existing Trading Partner with 005010 capabilities, 1EDISource can assist you with any 005010 Payer requirements.

Here are some important dates to remember for your 005010 Implementation:

• Date of the regulation: March 17, 2009

• Level I compliance to begin by December 31, 2010 … Level I compliance means “that a covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing.”

• Level II compliance by December 31, 2011 … Level II compliance means “that a covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards.”

• All covered entities must be fully compliant on January 1, 2012 …