In March when the Centers for Medicare & Medicaid Services (CMS) extended the enforcement deadline for HIPAA 5010 compliance to July 1, it was an admission that the transition wasn't going well.
It's good news that the federal government isn't going to fine anyone for non-compliance yet. But it does little for the healthcare providers who are experiencing medical claim denials. Reimbursements are being held up without much help from the payers rejecting claims.
Luckily the government is here to help.
First, it compiled a guide to 5010 rejections and how to fix them. It's an incredibly useful document.
Second, it partnered with the Workgroup for Electronic Data Interchange (WEDI) to sort through the issues and communicate how to solve them. WEDI created a 5010 Reporting System to allow providers to register their issues. The goal was to collect issues and offer answers.
I don't see any answers yet. But CMS and WEDI did host a webinar that covers some of the bigger HIPAA 5010 compliance issues -- such as interpretation of the situational rule and why the billing provider address triggered rejections. The discussion is very detailed and long. But it probably will take less time to replay the webinar than wait on hold when calling the payers.