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PCC Frustrated with Payers' Lack of 5010 Readiness
Date:4/19/2011

WINOOSKI, Vt., April 19, 2011 /PRNewswire/ -- Physician's Computer Company (PCC) – a Vermont pediatric software developer that is ready to begin full production of the updated 5010 transaction standard for electronic claims and claims status – is frustrated by a lack of readiness among its payers.

An ICD-10/5010 Readiness Survey released in January by the Health Information and Management Systems Society (HIMSS), indicates an estimated 1/3 of health care providers are, as yet, unprepared for the Jan. 1, 2012 compliance deadline for all health care entities to convert to the new Health Insurance Portability and Accountability Act (HIPAA) standard.

The company's predicament reflects a widespread industry concern that suggests compliance milestones, as outlined by the Centers for Medicare and Medicaid Services (CMS), may not be met.

PCC and two of its insurance carriers have been in full production mode with 5010 since January, giving the company a jump on the Jan. 1, 2012. The company's direct-to-payer connections with Blue Cross of Northeastern Pennsylvania and Highmark Blue Shield have validated its readiness to send and receive the updated claims form, but the vendor continues to wait for the rest of its more than three-dozen insurers and clearinghouse partners to meet their own internal deadlines for 5010 compliance before they can test with PCC.

According to CMS' suggestions for implementation, health care entities should have completed the internal testing necessary to prove it can send and receive 5010 transactions by December 2010 and should already be several months into the external testing phase with trading partners, such as PCC.

"We're basically in a holding pattern with a lot of our partners, and worse, the majority aren't even ready to do the testing," said Justin Ballou, PCC's Electronic Data Interchange Team leader. "Most just don't have plans they can provide us beyond saying, 'We'll be ready by Jan.
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SOURCE Physician's Computer Company
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