Delta Dental Implements HIPAA Standard for Electronic Transfers

Delta Dental is pleased to announce that we installed the new HIPAA electronic claim and inquiry standard on December 21, 2011. Electronic claims and inquiries are now being transmitted in accordance with this standard.

As of January 1, 2012, dentists (as well as clearinghouses, health plans and others) are required by federal law to use upgraded standards for electronic transactions, including claims and inquiry transmissions. The new standard (also called the “5010” standard) replaces the current “4010” standard, which is widely recognized as being outdated. The new standard is intended to streamline data exchanges by increasing transaction uniformity.

Most clearinghouses completed their certifications by January 1. Delta Dental greatly appreciates the commitment and collaboration of all involved to reach this major milestone and prevent any disruption of service to the dental community.

Implementation of the new 5010 standard is the first phase of industry efforts to improve the usability of the electronic transactions for dental claims. Additional rules to standardize the use of transactions will be implemented between 2012 and 2016.

This mandate, published in a U.S. Department of Health and Human Services (HHS) final rule under the Administrative Simplification Provisions of the Health Insurance Portability and Accountability Act (HIPAA), supports the continued transformation of the U.S. health care system toward a comprehensive electronic data exchange environment.

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