Affinity Health Plan

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  • Ensure a smooth 5010 upgrade with CMS online resources

    The Version 5010 upgrade deadline was January 1, 2012. You should be finalizing your upgrade to Version 5010 if you have not yet done so.

    The Centers for Medicare and Medicaid Services (CMS) initiated an enforcement discretion period to give everyone covered by HIPAA additional time to complete testing and meet compliance. The discretion period ends on June 30, 2012. The Version 5010 transaction standards differ from those of Version 4010 and 4010A, and HIPAA-covered entities need to keep a few things in mind to avoid unnecessary rejections of 5010 claims.

    Resources for 5010 transition from CMS

    CMS is committed to helping you successfully upgrade to Version 5010 by providing resources on the CMS ICD-10 website to understand and manage your upgrade. Take a look at the Version 5010 section of the CMS ICD-10 website to find out more about the upgrade and see the available resources.

    CMS has also created several helpful fact sheets on Version 5010, which include: 

    »   Version 5010, D.0 and 3.0 Basics

    Provides an overview of Version 5010, D.0, and 3.0.

    »   FAQs: Versions 5010 and D.0 Basics

    Lists many frequently asked questions about the Version 5010 upgrade.

    »   Version 5010 Testing Readiness Fact Sheet 

    Explains the 5010 upgrade and necessary internal and external testing.

    »   Version 5010: Ensuring a Smooth Transition

    Provides steps to assist your upgrade to Version 5010.

    You can learn more from these additional resources:

    Preparing for the 5010 transaction standard

    The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires the Secretary of the Department of Health and Human Services (HHS) to adopt standards that covered entities (health plans, health care clearinghouses, and certain health care providers) must use when electronically conducting certain health care administrative transactions, such as claims, remittance, and eligibility requests and responses.  Learn more

    Have you started external testing of version 5010?

    All HIPAA covered entities that submit transactions electronically are required to upgrade from Version 4010/4010A to Version 5010 transaction standards by January 1, 2012. Learn more

    Keep Up to Date on Version 5010 and ICD-10

    Please visit the CMS ICD-10 website for the latest news and resources to help you prepare, and to download and share the implementation widget today.

    Find more resources for the transition to ICD-10 on Affinity's dedicated web page.