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HIPAA 5010 Conversion Services
Standards set forth by the United States Department of Health and Human Services on Jan. 15, 2009 specify that X12 Electronic Data Interchange (EDI) transaction definitions for version 5010 – used in conjunction with HIPAA transactions – must be completed by January 2013. The new standards also require healthcare providers to comply with an International Classification of Diseases (ICD) standard update, from ICD-9 to ICD-10 by October 2013.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 required the Department of Health and Human Services (HHS) to adopt information standards to be used in all HIPAA covered electronic health care transactions. The current standard electronic transaction version is 4010A1 and the new updated version is 5010. The Centers for Medicare and Medicaid Services (CMS) and HHS have mandated that the new 5010 standards are adopted by all healthcare entities by January 01, 2012.
Technosoft offers a complete solution or individual components to address your most pressing planning, implementation and execution requirements to comply with HIPAA 5010. Services that we provide include:
Impact / Gap Analysis: We provide a detailed Gap Report that identifies all the required changes in applicable transactions, business applications and business processes.
Strategy & Solution Development: Based on the gap analysis and impact assessment, our consultants provide tailor-made solutions based on customer requirements. The solution and strategy accounts for time and resource constraints and provides recommendations for vendor based tools, solution strategy or customized application development and maintenance.
Application Remediation: Applying deep and diverse experience with Application Development and Maintenance (ADM), Technosoft provides effective remediation of all applications that participate in the 5010 transactions. Remediation may include partial to complete remediation based on the solution and strategy adopted.
Data Extraction, Conversion and Reporting: Depending on the transition strategy selected, there may be a need to extract, transform and convert 4010 Claims to 5010 format for operations. Leveraging our expertise in Business Intelligence (BI) and Data Warehouse (DW) projects, Technosoft provides tailored solutions based on specific customer needs.
Process Re-engineering to support 5010: Additional data elements proposed in 5010 present unique opportunities for all healthcare entities to leverage the new information to their advantage. Utilizing our IT, Healthcare and business domain expertise, Technosoft helps customers reengineer their business processes as required.
Product or Tool Implementation and Integration: Many organizations process HIPAA transactions using third party tools. Leveraging technical and business domain knowledge combined with industry partnerships, we offer implementation, upgrade and integration of new and existing solutions.
Compliance Verification & Validation: Before going to production, Technosoft provides verification and validation services of all external interfaces with trading partners. We assure 5010 compliance and all the changes to the applications are working as desired.
Transition Management: Adding to the complexity of the transition from 4010 to 5010 is the need to work in both 4010 and 5010 mode for a considerable period of time. Technosoft’s customized solution not only provides business continuity throughout the transition, but also ensures minimal impact to productivity and customer/partner satisfaction.
Training: Because of the magnitude and pervasiveness of this change, the need to train a large number of users on updated applications and business processes may pose scalability issues. Technosoft training capabilities can alleviate scalability issues.
Compliance Audit: Utilizing deep domain expertise and knowledge of HIPAA, Technosoft provides an independent audit and assessment of the 5010 capabilities that provide enhanced confidence and assurance.
Consulting Services to use 5010 version effectively and efficiently: To help organizations leverage added capabilities and intended usages of the new data elements, Technosoft offers consulting services based on customer business improvement objectives.