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Medical Billing Software Users Sending Electronic Claims Have Small Timeline Reprieve for ANSI 5010 Deadline.

US Governement recently extended the compliance deadline for sending ANSI 5010 compliant electronic claims through clearinghouses and directly to medicare.


Medical Billing Software demo and live billing users still sending claims using the old ANSI 4010 standards will be happy to know that the Centers for Medicare and Medicaid (CMS) has extended the enforcement deadline for sending compliant ANSI 5010 claims to June 30, 2012 for any covered entity that is required to comply with the updated transactions standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Clearinghouses, health plans, providers and software companies have been making steady progress : the Medicare Fee-for-Service (FFS) program is currently reporting successful receipt and processing of over 90 percent of all Part B claims in the Version 5010 format.  Commercial insurance plans are reporting similar numbers.  State Medicaid agencies are showing progress as well, and some have made a full transition to Version 5010.

While there are still a variety of unsolved issues and challenges that are hampering full implementation,  the CMS believes that these remaining issues warrant an extension of enforcement discretion to ensure that all entities can complete the transition. CMS expects that transition statistics will reach 98 percent industry wide by the end of the enforcement discretion period.

Medical billing software program users are urged to make sure they are in compliance with the new ANSI 5010 standards by checking with their computer dealer and or software vendor company.  Some insurance billing software users may be required to upgrade their software in order to comply with the new standards to be enforced June 30, 2010 for medical billing software demo users.


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