On January 16, 2009, the U.S Secretary of Health and Human Services issued Final Rules for updated versions to the electronic transactions originally outlined under the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The legislation mandates industry-wide migration from the current 4010A1 record standard to a newly established 5010 version, for health information transactions governed under HIPAA. The legislation became effective on January 1, 2011, and accommodates a one-year transition period for all entities to achieve compliance by January 1, 2012.

System Designs, Inc. has been hard at work for several years enhancing the PC-ACE Pro32 claims processing system to support the 5010 format. PC-ACE Pro32 is fully compliant with version 5010, including the June 2010 "errata" changes. System Designs, Inc. has been working closely with Medicare contractors and other health plans during 5010 planning and testing to insure a smooth transition to the new version.

PC-ACE Pro32 Bridges The Gap

PC-ACE Pro32 is a great solution for any provider looking to submit electronic claims in 5010 format. Many providers use the product in standalone mode to hand key claims for submission to Medicare as well as many other government and private health plans. PC-ACE Pro32 also supports claim import from ANSI-837 (HIPAA) and several other electronic formats, making it a powerful addition to existing practice management and electronic claims processing systems. With the 5010 compliance deadline fast approaching, we believe PC-ACE Pro32 will be called upon by many providers to "bridge the gap" from their existing electronic claims system to the new 5010 mandated standard format.

Let's suppose, for example, that your current claims solution vendor won't meet the January 1, 2012 deadline (or you're just not comfortable holding out to see if they do). Because 5010 implementation is costly for vendors, it may even be that they aren't ever planning to support the new 5010 mandated format. That's where PC-ACE Pro32 comes to the rescue! The graphic below illustrates how PC-ACE Pro32 can "bridge the gap" between your existing system and the new 5010 format.

PC-ACE Pro32 can import the 4010A1 electronic claim file (or several other older electronic versions) produced by your current system. You can then take advantage of the extensive capabilities of our product to process the imported claims. We believe you'll find that PC-ACE Pro32 has much to offer in addition to the version translation feature. For example, all imported claims must pass our rigorous 5010 edit set to insure that the resulting output will meet all requirements of the HIPAA implementation guides. We also review CMS change requests each quarter and implement many of the Medicare business edits, so you'll be able to catch and correct problems with your claims before they're transmitted. This benefit can lead to a greatly reduced claim rejection rate. Once your claims are error-free, a few clicks of the mouse will produce a 5010-compliant ANSI-837 claim transaction file ready for submission to Medicare, a clearinghouse, or numerous other health plans.

Why Wait? ... Act Now!

Don't wait until the last minute for your current claims solution vendor to deliver a 5010-compliant solution. Call us now at 214-340-3450 to discuss how PC-ACE Pro32 can be your HIPAA 5010 solution! If you prefer, click here to inquire online about our 5010-compliant solutions. One of our sales staff will respond promptly to your inquiry.