Nuesoft Ready for ANSI 5010 Transition


The entire healthcare industry is gearing up for the update from the current Centers for Medicare and Medicaid (CMS) American National Standards Institute (ANSI) form  X12-N 837 version 4010A1 to the improved ANSI X12 version 5010. The transition applies to any electronic transactions covered by HIPAA, including claims, remittance advice, eligibility verification, and referrals. All “covered entities” -- including providers, health plans, clearinghouses and billing agents, must be fully compliant by January 1, 2012.


At that time, covered entities will also be required to move from the National Council for Prescription Drug Program (NCPDP) version 5.1 form to the new D.0 format. CMS is already accepting the new forms and has made it clear that there will be no extension on the deadline.


The format changes are a precursor to the switch from ICD-9 codes to the new International Classification of Diseases (ICD-10) code set, which is scheduled to take effect on Oct. 1, 2013.  The current 4010A1 form doesn’t support the expanded set of codes, and the new form further standardizes electronic transmissions of all HIPAA related documents. Currently, each payer has proprietary ways of submitting information electronically. The 5010 transition will make the process more uniform, create efficiencies in administration and clarify communication.


Nuesoft Readiness
Nuesoft has been working behind the scenes to ensure its clients continue to get paid after the deadline arrives.  

“We are already achieving Level One compliance and transmitting the 5010 form with some payers,” said Steve Rogers, director of product management.


The cloud-computing architecture of Nuesoft’s software allows for greater flexibility than client-server systems that require each computer to have the new software installed by an IT professional. Because Nuesoft is Internet-based or Software-as-a-Service (SaaS), the system can be updated across all of its more than 15,000 users at once.


“Nuesoft being SaaS-based is hugely beneficial when it comes to an update like this,” said Rogers. “We are able to test and bring online the new 5010 changes with zero impact on our customers. When modifications are made with our cloud computing model all of our customers get the benefit of the change the next time they login to our application.”


Smooth Client Transition
If you are getting curious about what you need to prepare for the switch, know that there is nothing. All Nuesoft clients receive this update free and will not see any discernable change in the system or the way the practice interacts with payers. 


“As we act as the clearinghouse for all e-claims transmitted by our customers, we have a dedicated EDI team that manages the data flow and interfaces with the payers,” said Rogers. “Because of this, most of the changes required for 5010 are not changes in the NueMD application itself but rather is handled by our EDI team.  Nuesoft customers will continue to transmit and process claims just as they do today.  The vast majority of the changes deal with the formatting of data sent between the clearinghouse and the payer, and due to our architecture did not require software changes in our NueMD application.”


This means that all Nuesoft clients will be transmitting using the new form when the deadline arrives.

“I feel confident about how Nuesoft is handling the transition, and am assured that my clients will continue getting paid with no down time when the deadline arrives,” said Barbara Dunn, president of MedRecovery Solutions, Inc. and Nuesoft client.

As the date nears we will continue to communicate where we are with the transition, so you feel confident. We will make sure that you will continue to file claims, receive payments, and decrease potential for any customer service issues.


If you would like more information about the transition to the ANSI-5010 form, please review this podcast beginning on October 1, or review this fact sheet.