HIPAA 5010 Compliance
– EDS Transition

The Centers for Medicare and Medicaid Services (CMS) is underway with implementation activities to convert from Health Insurance Portability and Accountability Act (HIPAA) Accredited Standards Committee (ASC) X12 version 4010A1 to ASC X12 version 5010 and National Council for Prescription Drug Programs (NCPDP) version 5.1 to NCPDP version D.0. The Secretary of the Department of Health and Human Services (HHS) has adopted ASC X12 version 5010 and NCPDP version D.0 as the next HIPAA standard for HIPAA covered transactions. The final rule was published on January 16, 2009.

HealthcareData Company, LLC (HDC), is ready to assist Medicare Advantage Organization with transitioning from the Risk-Adjusted Performance system to the Encounter Data Submission program. Beginning with the current claims system, we will evaluate and review processes, programming code, and data sets used to produce a fully compliant 5010 claim for submission into CMS’ Encounter Data Processing System.

HDC possesses the necessary skills and expertise for this project:

• More than a decade of experience conducting healthcare data source review, programming and source code review, and projects of similar size and scope.
• Knowledge of 5010 Record Layout, including changes and differences from the 4010A1 version.
• Experience working with vendors or delegated entities to obtain data for evaluation and review.
• Operational policies and procedures follow HIPAA privacy and security requirements.

HDC has the operational capabilities to successfully complete this task:

• HDC has a secure client portal for the exchange of sensitive documentation and information.
• HDC operates in an environment that is fully compliant with HIPAA privacy and security requirements.

Contact HDC to provide services for a smooth transition to the HIPAA Accredited Standards Committee version 5010!

Learn more and get started. Call Paul Ackroyd, MBA, CPA, Sr Vice President, Audit, at (717) 458-0554; or email him at pjackroyd@hdcdata.com.