HIPAA 5010/HIPAA Simplified Update for Institutional



We are pleased to announce that Emdeon has received notification that we have met the requirements of the EHNAC 5010 Readiness Assessment Program. Emdeon received a score of 100%, which further evidences Emdeon’s commitment to ensure compliance with HIPAA 5010.

In addition to this industry recognition, Emdeon continues to guide our customers successfully through the migration to the X12 5010 and NCPDP D.0 versions of the HIPAA transaction standards. We have updated our gap analysis documents to include the recent 5010 Errata changes and enhanced our 5010 systems and solutions to support the Errata versions of HIPAA transactions. The Errata versions of the gap analysis documents are available at the HIPAA Simplified website under the ‘Downloads’ section.

We strive to provide you with the most updated and accurate information regarding our readiness for HIPAA 5010. Please see below for answers to the most commonly asked questions regarding HIPAA 5010.

What is Emdeon’s current state and plans for HIPAA 5010 testing?
Emdeon is currently testing and implementing 5010 with submitters and payers. The late release of the Errata changes to the 5010 transaction standards further constricted the already narrow 5010 testing and conversion window. Nevertheless, as you can see in the list below, Emdeon has initiated submitter and payer testing on all 5010 transactions.

Errata Beta testing in process:

• 837 Institutional claims
• 837 Professional claims
• 835 ERAs
• 270/271 Eligibility verification
• 837 Dental claims
Emdeon is also testing the Final Rule version with submitters and payers for the HIPAA X12 transactions that were not included in the Errata revisions:
• 276/277 Claim Status
• 278 Referral/Authorization

What Emdeon solutions are impacted by 5010?
5010 impacts eligibility, claim, claim status and remittance transactions. The associated Emdeon solutions impacted by 5010 include our clearinghouse, as well as:

• Emdeon Assistant
• Emdeon Receivables Analytics
• Emdeon Claim Master®
• Emdeon Payment Manager
• Emdeon AccuPost
• Emdeon Office

Note: HBS and Legacy Claim Master products are NOT being modified to be 5010 compliant. Clients on these products are already being migrated to the latest release of Emdeon Claim Master to meet 5010 requirements. These migrations will be complete no later than December 31, 2011.

How will my organization be notified of any updates if required?
Emdeon is actively finalizing a global plan which will provide various communications to our clients throughout the year. In addition, fact sheets are available for each solution at the HIPAA Simplified website.

What is the timeline(s) of events?
Emdeon is committed to be fully compliant prior to the HIPAA 5010 January 1st, 2012 compliance date, however this will vary based on solution, transaction, payer readiness and client readiness. Our goal is to have all Emdeon solutions modified and testing complete by the end of the year in order to be ready for the January 1st compliance date.

Where can I obtain additional information about HIPAA 5010?
Emdeon created a valuable web resource available to all industry stakeholders titled HIPAA Simplified, which may be found at hipaasimplified.com. HIPAA Simplified is a one-stop online resource that features gap analysis, business level documentation, webinars, timelines for the transition and testing information for our customers.

Thank you for trusting Emdeon as your source for HIPAA readiness. We work diligently to deliver solutions that enable our customers to seamlessly meet these industry regulatory requirements.



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