Last March, the Centers for Medicare & Medicaid Services (CMS) delayed enforcement of the Health Insurance Portability and Accountability Act (HIPAA) Version 5010 for the second time due to concerns that the industry was still experiencing significant implementation problems.
Starting July 1, CMS will begin enforcement. That means all electronic submitters must transition to the upgraded HIPAA-compliant electronic formats.
After June 29, 2012, at 3 p.m. the discretionary period will end. Any claim submitted in the 4010 format after that time will be rejected, and you will receive a 203 error report.
If you have any problems with HIPAA Version 5010 on or after July 1, contact your vendor or clearinghouse to identify and discuss problems.