Mirean Coleman, MSW, LICSW, CT
Effective January 1, 2012, clinical social workers and other health care providers, health care clearinghouses, covered entities, and business associates who use electronic transactions mandated by the Health Insurance Portability and Accountability Act (HIPAA), will be required to replace the current software, Version 4010/4010A standards, with Version 5010 standards. Version 5010 updates standards including claims submission and status, remittance advice, eligibility, and referral authorizations. Electronic transactions that do not use Version 5010 beginning January 2012, will be rejected for non-compliance with HIPAA electronic transactions. Rejections include denial of reimbursement.
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