5010 Information for Providers

The new 5010 standard that governs electronic submission of claims takes effect January 1st, 2012.

Preparing for 5010

As a provider, if you submit claims electronically, you must work with your billing agent, clearinghouse or software vendor to verify 5010 compliance. Check with your vendors to be sure they will be ready.

Here are some key questions to ask:

• Discuss their plan for upgrading their systems and software to meet 5010 standards.
• Determine when their systems will be upgraded and ready for testing.
• Learn their plan for testing for 5010. Resources are available to assist with testing.
• Find out whether they will support concurrent 4010 and 5010 submissions and if so, for how long.
• Given that 5010 introduces many changes, determine whether your billing agent or clearinghouse will require you to re-enroll, and if so, what information they will need for the re-enrollment.
• Ask if these upgrades will change their fee structure.

Coming Soon: E-mail Notifications

In the near future it will be easy to stay in touch because you will be able to subscribe to receive e-mails whenever there is new information about 5010. What can you expect to receive in the e-mails?

• News on the 5010 project
• Details on testing requirements
• Dates for testing availability
• Instructions for submitting test files
• Newsletters
• Helpful hints for successful claims submissions

This page will have instructions on how to register your email address to receive the latest news on 5010.

Your email address will not be shared with anybody or used for any purpose other than to receive information related to 5010.