Under the Health Insurance Portability and Accountability Act (HIPAA), healthcare providers are required to follow certain standards for electronic transactions, including claims submission, remittance advice, eligibility, claims status, and referral authorizations. On Jan. 1, 2012, these standards were upgraded to the 5010 version.
To help AAOS members with the transition, Gateway EDI—our partner in the AAOS Revenue Management Program—has a “5010 FAQ & Tips” page on its website. “Tips of the week” cover issues ranging from the need to use an actual street address (rather than a lock box or post office box) and a full 9-digit zip code for the billing provider address to the requirement that both the rental and purchase price information for the provision of durable medical equipment be provided.
Access the “5010 FAQ & Tips” by clicking on the HIPAA 5010 link on the Gateway EDI/AAOS website (www.gatewayedi.com/aaos) More information about the AAOS Revenue Management Program powered by Gateway EDI is also available at www.gatewayedi.com/aaos