January 1, 2012 is the deadline. HIPAA X.12 5010 upgrades should now be in place, and external integrated partner testing in its last phases. Unfortunately there are still some facilities out there that are struggling toward this migration and are at risk of not meeting the deadline we all face in January 2012.
There are many reasons organizations are challenged in completing these 5010 migration plans. A recent 5010 assessment at a full-service 300+ bed regional medical facility uncovered a few of those reasons. This facility had many balls in the air in terms of projects, upgrades, year-end processing, and key personnel changes – basically all the things you wouldn’t want at the beginning, middle, or even the end of a major project! Even with these challenges don’t sacrifice a thorough and balanced comprehensive approach, fully defining scope, technical and non-technical impacts, rapidly completing remediation planning, and assisting with risk management.
As you look at your MEDITECH 5010 Migration progress keep in mind these 5 key points as you gauge your progress to completion:
- Enterprise Wide System Documentation is not always readily available from the client or the client’s vendors but can be overcome through thorough internal technical interviews. These one-on-ones are invaluable and will allow you to discern fact from assumptions, develop enterprise wide conclusions supported by the implementation notes (DTS) and complete additional systems inventory gathering and analysis. Always ask questions to validate.
- Verification of key transaction processes - The client using MEDITECH as the Core HIS was unknowingly generating a UB04 Print Image submission to the client’s clearinghouse trading partner, not an 837I transaction as had been originally conveyed. Verification of key transaction processes from multiple sources both technical and non-technical is key to the integrity of the assessment and must include validation with external partners.
- The 5010 837I Implementation contains a new program in BAR - 5010 INST where design and post-upgrade configuration will be required as well as possible workflow modification and potential training needs. NOTE: 4010 processing of 835 remittance advice will be disabled with the 5010 upgrade of the 837I transaction (Special setup is required to process 4010 835).
- The 5010 835 Implementation contains a new EDI program BAR.5010.REMIT where design and post-upgrade configuration will be required as well as possible workflow modification and potential training needs. This program also produces several new remittance reports and testing involves a new 5010 Inbox Delivery Service. NOTE: Special setup is required to process 4010 835.
- The 5010 Expanded Pages for the UB04 Implementation will require design and post-upgrade configuration to print the newly expanded pages for 12 new fields. Additionally, existing Customer Defined Queries need review and potential editing in order to display additional information to the claim.
Ben Dyar, Sr. Consultant
Santa Rosa Consulting, Inc.