February 2011 Newsletter
A Look in the Mirror:
How Ready Are You for ANSI 5010?
For over a year now, Quadax has been preparing for the transition to the ANSI 5010 format. Fields have been added, databases expanded, programming logic updated, maps revised, and the list goes on. Simply put, Quadax has already made a slew of wide-ranging additions, modifications, and updates (both upfront and behind the scenes) to our claims processing software products to be in compliance with ANSI 5010 specifications. With a deadline for full compliance by January 1, 2012 looming in the not-too-distant future, time is – without question – of the essence to ensure our readiness as an electronic medical claims vendor.
But what about the other side of the equation, our clients? How are providers doing in not only preparing, but actually making the necessary changes on their end to accommodate ANSI 5010? The answer, at least according to the most recent Healthcare Information and Management Systems Society (HIMSS) 5010 Industry Readiness survey, is “Fair.” In short, the survey indicates that while progress is being made toward 5010 compliance, many healthcare providers are lagging behind the timeline set by the Centers for Medicare and Medicaid Services.
The 2010 HIMSS Survey on ICD-10\5010 Industry Readiness was intended to assess the progress of key industry stakeholders, particularly providers, in preparing for the 5010 conversion, and in 2010 was conducted in conjunction with the American Association of Healthcare Administrative Management (AAHAM), a membership organization that focuses on healthcare administration. In 2009, HIMSS initiated a survey among its membership to assess the level of 5010 projects, activity, and readiness. The first survey was completed by 56 organizations. In contrast, the most recent survey was completed by 202 organizations – more than triple the number of respondents to the 2009 survey – between April/May 2010. Seventy-four percent of the respondents were from hospitals, while the remaining 16% were from physician practices.
Some of the more notable statistics for 5010 readiness include:
- 25% have a specific 5010 project with staffing and resources identified, but the same percent have no plans currently in place.
- 40% have either started or completed a 5010 impact assessment, but 35% have not even considered it.
- 51% cite other “technology projects” as the most significant competing initiatives with the transition to 5010, while 49% indicate that “EHR Meaningful Use” is the most notable competition with 5010.
- 51% indicate that a lack of necessary staffing is the biggest obstacle to their 5010 efforts, while 47% indicate it’s the lack of information; 31% said lack of funding is the number one obstacle.
Taken as a whole, these factors not only suggest that most provider testing will be conducted later in 2011, but also that few are taking advantage of the opportunity to implement with trading partners before the January 1, 2012 mandated compliance date. To be fair, some of this testing tardiness can be attributed to the fact that the official ANSI 5010 Companion Guide has still not been published. The most recent word from CMS is that the Companion Guide will be available “sometime in February 2011.”
To assist providers with the transition to both 5010 and ICD-10, HIMSS created a 5010/ICD-10 Resource Center, which serves as an excellent resource for providers that are in the middle of testing, or those that have yet to begin. It has also provided a number of “Reasonable Practices” for providers to implement 5010, most notably:
- Focusing on priority transactions and high volume trading partners
- Testing aggressively
- Implementing early where possible
As always, Quadax is here to assist our clients in any we can to make the transition to 5010 as seamless and trouble-free as possible. Now it’s up to you to “look in the mirror” to determine what you need to do and how we can help!