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Are You Ready?: HIPAA 5010 Transition

Beginning January 1, 2012, any health care entity that submits electronic standard transactions to AmeriHealth must comply with HIPAA 5010 (errata version). After this date, version 4010A will no longer be valid.

AmeriHealth is preparing for the transition to 5010 by testing directly with our trading partners. We ask that you speak with your trading partner (or through whomever you submit your claims) in order to ensure that your trading partner is compliant and ready to electronically submit standard transactions using version 5010 by January 1, 2012. Providers should take an active role in ensuring their trading partners are on track with 5010 compliance.

Important billing change

A new 5010 billing requirement stipulates that providers can no longer submit a PO Box or lockbox in the Billing Provider area on professional and institutional claims. A physical street address must be listed for the Billing Provider and the Service Facility location.

Inquiries

If you have specific questions surrounding the transition to 5010, please refer to the HIPAA 5010 Frequently Asked Questions (FAQ) found on our website at www.amerihealth.com/hipaa5010. The FAQ contains the most current information we have at this time. We will continue to update the FAQ as new information becomes available.

Please continue to check Partners in Health Update, the NaviNet^® web portal, and www.amerihealth.com/providers for important updates and information regarding the conversion to 5010.