• HIPAA 5010

    The U.S. Department of Health and Human Services has adopted the 5010 version as the standard format for electronic health claim transactions. HIPAA Version 5010 replaces Version 4010/4010A1 standards, and accommodates ICD-10 code sets. Premera has a corporate-wide business plan for achieving full compliance with the electronic healthcare transactions requirements and all Premera applications that involve employer groups, contracted providers (physicians, dentists, hospitals), vendors, and trading partners. Information will be updated regularly here on the provider page. This includes information about future ICD-10 implementation.

    Following are key dates for the transition from version 4010A1 to 5010: 

    • Payers to begin Trading Partner testing on Jan. 1, 2011
    • Compliance testing completed by Dec. 31, 2011
    • Full transition compliance for all parties expected by Jan. 1, 2012

    How can my providers organization prepare? 

    • Talk with your practice management system vendors about accommodations for Version 5010
    • Discuss your implementation plans with all your billing agents and payers to ensure a smooth transition
    • Conduct testing with payers and billing agents using Version 5010
    • Stay up-to-date on resources and information from CMS


    CMS Version 5010 Web site