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Latest 5010 News

Provider Next Steps:

Providers should contact their vendors to see what their readiness is for 5010 and their timeline. For the most part, this will be a transparent change to providers, but there are some key questions you should ask your vendor:

  • When will you be upgrading your systems?
  • Do we need to submit files to you for testing?
  • Are there fees associated with these changes?
  • Are any of the changes going to affect your office directly?


Vendor Testing

  • If you use a vendor, you will probably not need to test individually with your vendor
  • We will continue to test with vendors from mid-March through the end of December 2011, if necessary
  • We will accept version 4010A1 (current version) 837 claim files through the remainder of 2011
  • Claim files not in the 5010 837 claim format will not be accepted on or after January 1, 2012


Additional 5010 Transaction changes:


  • HealtheNet will also be affected by 5010
  • Work is also underway to enhance the ‘look and feel’ of the HealtheNet screens in conjunction with the 5010 upgrade