HIPAA 5010 Transactions Standards & Code Sets (HIPAA 5010) readiness statement
On January 16, 2009, the U.S. Department of Health and Human Services (HHS) released the final rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regarding updated standards for electronic healthcare transactions: X12 Version HIPAA 5010.
MagnaCare Readiness
MagnaCare is committed to delivering excellent service and has adopted HIPAA transactions and code sets, including compliance with and support of HIPAA 5010.
Please note the replacement of the original base versions by the Errata in the chart below. Transactions not supported by MagnaCare are shown as “Not applicable.” |
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Transactions Affected by the Errata | Errata Version Compliance January 1, 2012 |
Base Version Compliance January 1, 2012 |
---|---|---|
820 Premium Payment |
005010X218 |
Not Applicable |
834 Benefit Enrollment and Maintenance |
005010X220 |
|
835 Health Care Claim Payment/Advice |
005010X221 |
|
837 Health Care Claim: Professional |
005010X222 |
|
837 Health Care Claim: Institutional |
005010X223 |
|
837 Health Care Claim: Dental |
005010X224 |
Not Applicable |
270/271 Health Care Eligibility Benefit Inquiry and Response |
005010X279 |
Payor ID: MAGNA |
276/277 Claim Status Inquiry/Response |
005010X212 |
Payor ID: MAGNA |
278 Health Care Claim Services Requests for Review and Response |
005010X217 |
Not Applicable |
999 Implementation Acknowledgement For Health Care Insurance |
005010X231 |
005010X231A1 |
The final rule adopts X12 Version 5010 Errata for HIPAA transactions.
Modifications were introduced as a result of the current 4010A1 electronic transaction standards being outdated and including rules that no longer align with business practices in the healthcare industry.
The HIPAA 5010 final rule applies to all HIPAA covered entities, including health plans, healthcare clearinghouses, and certain healthcare providers. Version 5010 is designed to bring a more consistent use of healthcare transactions to the industry, ultimately making it easier for healthcare providers to submit the same information to all insurance carriers.
5010 Readiness FAQ