Testing 5010 with Trading Partners

When the 5010 final rule becomes effective on March 17, 2009, health plans can begin testing with willing trading partners the 5010 standard transactions alongside the current 4010/4010A1 transactions standards. The improvements in the 5010 version 835 Health Care Payment and Remittance Advice transaction (835) for all claim types may benefit both health plans and healthcare providers. “Correct implementation of the X12 835 will reduce phone calls to health plans, reduce appeals due to incomplete information, eliminate unnecessary customer support, and reduce the cost of sending and processing paper remittance advices” [74 Federal Register 3298]. Remember, use of the 5010 version 835 transaction standard “in advance of the mandatory compliance date is permissible, based upon mutual agreement by trading partners” [74 Federal Register 3310].

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