Is Your Billing Partner Capable of Handling HIPAA 5010 Changes?


HIPAA Compliance and HIPAA GuidelinesTechnology updates are expensive to implement and maintain and since you have a busy practice to run, outsourcing coding and billing requirements makes a lot of sense. It also relieves you from the burden of HIPAA compliance when handling claim filing and billing tasks. However, if your medical billing company has not updated their software or trained staff for handling HIPAA changes, it might result in damage to your reputation and reimbursements.

Practices need to understand that HIPAA-5010 is as important as implementation of ICD-10. ICD-10 coding will not be possible if you fail to implement the 5010 version. The new version will apply to transactions with all payers, including Medicare and Medicaid and also regulate the transmission of PHI.

So, you need to find out if the outsourced company is capable of handling the stringent requirements because only then the chances of claim denials and security breaches will be eliminated.

How will HIPAA-5010 affect your practice?

In order to meet HIPAA-5010 requirements, practices will have to update their software and create a plan for implementation of these changes to the entire system. The new version will affect all providers who submit administrative transactions such as claim filing, receiving of remittance advice or the task of checking patient’s eligibility electronically.

See more information visit:

The collection and reporting of data will have to be done in a different format. Even though HIPAA-5010 has been introduced to make things easy for providers, implementation of these requirements amidst time constraint can result in billing and medical coding challenges, affecting reimbursements and reputation of your practice.

What you need to check with your billing partner?

  • Billing companies need to update the software on a yearly basis to help physicians sail through HIPAA changes. Such companies are covered entities for which implementation of HIPAA-5010 standards are mandatory as they transmit certain healthcare transactions electronically
  • Practices need to know if their billing company has upgraded their system for accommodating the 5010 version and if there will be any fee changes for the same. You can also send a test transaction to your billing company for ensuring the new system works well
  • It is essential for your medical billing company to be HIPAA compliant and stay up to date on any current rule changes, technology or regulations. This will not just help the company stay on top with quality coding and billing services but also ensure that PHI of your practice is being handled in a secure and private manner has been offering HIPAA compliant coding and billing services to providers across the US. The team at MBC is updated with billing reforms and HIPAA reforms on a constant basis and our main aim is to streamline your medical billing tasks while ensuring compliance to these changes. MBC also offers guidance to small as well as large practices so that they can better confirm to stringent HIPAA requirements. This will help doctors focus on quality patient care without worrying about compliance and other healthcare reforms.

This entry was posted in HIPAA / ACA / ACO and tagged , , , , , , , , , . Bookmark the permalink.


What are you looking for

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>