All HIPAA-covered entities must be fully compliant with 5010 on January 1, 2012. Medicare, Wisconsin Physicians Service Insurance Corp. (WPS), TriWest Healthcare Alliance, and TRICARE® are in compliance with HIPAA 5010. If you fail to prepare, it will be your business and cash flow that will be affected. If you rely on a vendor or clearinghouse to maintain your billing system, ask them about their plans for transitioning to the new 5010 format.
The HIPAA 4010 format cutoff date is December 30, 2011, 4:30 p.m. CST. Any 4010 files received after this time will be rejected.
If you currently receive your 835 Electronic Remittance Advice (ERA) in the X12 835 format, and have not converted to the 5010 format, these files will automatically be converted to the 835 5010A1 format on January 1, 2012.
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