HIPAA standard for electronic transactions changing in 2012

Beginning January 1, 2012, dentists (as well as clearinghouses, health plans and others) will be 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standard (also called the “5010” standard) replaces the current “4010” standard, which is widely recognized as being outdated.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.

Check with your practice management software vendor now about upgrading and testing your system to accommodate the new standard. Getting started now will also help prevent disruptions to your office administration next year when the new standard is in effect.

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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