HIPAA 5010

[Pruce Dental]

Can someone give me the dummies guide to HIPAA 5010? I use dentalexchange with opendental.

Do I need to do anything on my end to be ready or is it totally the clearinghouses problem?

What is different with the HIPAA 5010 standard?

[jordansparks]

Don't send 5010 until Jan 1. There is essentially no difference.
http://www.opendental.com/manual/eclaims.html

[Pruce Dental]

Thanks..I found where to select it in OD when the time comes...

[Smilesbypayet]

Thanks..I found where to select it in OD when the time comes...

I hadn't heard anything about this. What is HIPPA 5010, and where do I turn on the option in OD?

[jordansparks]

You don't need to worry about it.

[joshuab]

We just learned from our e-claim service, Renaissance, 5010 requires the billing provider to be a physical address. This would cause major problems Jan 1. If your using a PO Box (for billing provider) your claims could be denied soon.

We prefer using a PO Box (secure mail). Only option we heard is you might be able to set a mailing address with each insurance company but that would be a pain. We're going to switch to physical and continue to setup electronic payments with as many as we can.

[joshuab]

Dang. Just read a full 9 digit zip code is required for both billing and rendering provider. Am I reading the right stuff? Found this online: http://www.emdeon.com/5010/pdfs/HIPAA_S ... I-5010.pdf. Item # 18.

If true I can see insurance denying everything on account of this. They love new excuses to deny.

[jordansparks]

There is both a billing address and a pay-to address. the pay-to address can be a PO Box. I just added a section explaining this at the bottom of
http://www.opendental.com/manual/eclaim ... ities.html
We will support both addresses and it won't be a problem.
However(!!!), Renaissance does not use X-12. I've been harping on the shortcomings of the Renaissance format for years. We've had the X12 standard in the U.S. for over 10 years now. If you use a format like Renaissance that is non-standard, you're going to have problems from time to time. This is yet another example of where their non-standard format falls short. Renaissance cannot capture both addresses. They may have a workaround such as you calling them to set up your pay-to address ahead of time for all claims. I'm not sure.