WPC Launches “5010 Check-Up” Program to Help Providers Meet Compliance

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WPC Launches “5010 Check-Up” Program to Help Providers Meet Compliance

July 11, 2011

WPC Services, a full-service healthcare technology and business consulting subsidiary of Washington Publishing Company (WPC), today announced the launch of “5010 Check-Up”, an affordable program to help hospitals and health systems evaluate immediately their HIPAA 5010 conversion progress, identify business problems and make changes before the end of the year. Hospitals must convert from 4010 to version 5010 by Jan. 1, 2012, the new federally mandated ANSI X12 electronic standard for claims transactions necessary for ICD-10 codes adoption.

According to Eric Mueller, president of WPC Services, the company’s 5010 preparedness reviews have revealed a minimum of 150 issues commonly unidentified that could lead to health claims being rejected or denied.

“We launched 5010 Check-Up to quickly help providers lagging behind and operating under a limited budget to solve complex revenue cycle-specific problems to meet the compliance deadline in six months,” said Mueller. “Hospitals as well as payers are operating under the belief that 5010 involves mapping and technology issues exclusively, but 70 percent of 5010 involves business workflow changes affecting the entire billing cycle. Unless this critical element is incorporated into their readiness strategy, organizations will experience the doubling and possibly tripling of A/R days, patient dissatisfaction and severe cash flow interruptions.”

WPC Services’ “5010 Check-Up” program consists of a two-week 5010 review at the healthcare facility for a $20,000 flat fee. It entails the following:

  • 5010 overview. WPC Services outlines the data and business change requirements through a series of interactive discussions focused on the implications for the organization and its current progress to date.
  • Assessment of three transactions. Facilities choose up to three HIPAA transactions, concentrating on claims, eligibility verification, claims status and remittance advice. WPC Services works closely with providers’ business and I.T. leaders to examine the workflow, process and technology changes required by 5010 transactions.
  • Summary and findings report. WPC Services’ team presents recommendations to strengthen a hospital’s organizational readiness strategy to meet compliance standards, maintain business continuity and increase transaction efficiency in a 5010 environment.

According to an ICD-10 readiness survey released last May by The TriZetto Group, only 47 percent of insurers had mapped 4010 to 5010 files and only 9 percent had completed 5010 trading partner testing. An earlier readiness survey last January by the Healthcare Information and Management Systems Society (HIMSS) reported 48 percent of surveyed providers had a 5010 implementation plan in place by December 2010, and a third reported they either didn’t have a plan for testing or won’t test until the fourth quarter 2011.

“These findings indicate the majority of 5010 testing, which technically should have started last January, is beginning now until the end of 2011,” Mueller said. “The research also underscores the general lack of provider awareness of 5010 in requiring them to capture additional data during the patient visit. The abundance of new data necessitates the reengineering of revenue cycle processes concurrently with upgrading technology and reaching out to insurers and clearinghouses to monitor their 5010 readiness progress.”

The “5010 Check-Up” program is supported by WPC Services’ extensive healthcare electronic data interchange and standards expertise. “Our parent company, Washington Publishing Company, is the founding publisher of the ASC X12 implementation guides mandated for use under HIPAA,” he continued. “As the HIPAA industry expert, we are the ideal qualified compliance partner to help hospitals overcome the 5010 migration challenge on time, efficiently and cost effectively.”

About WPC Services

WPC Services is a full-service healthcare technology and business process consulting organization in Brentwood, Tenn. The practice is a growing extension of Seattle-based Washington Publishing Company (WPC), the founding publisher of HIPAA implementation guides and code sets. Anchored by its 30-plus year heritage, WPC Services provides technical, business process and compliance expertise. Its comprehensive solutions empower healthcare organizations to optimize operational performance and effectively manage complex business and technology change. Domain experts specialize in: application development, integration and interoperability, data analysis, trending and reporting, HIPAA compliance and readiness, ICD-10 readiness assessment and attestation, health I.T. training, electronic medical records adoption, health information exchange, payment reform, Accountable Care Organization qualifications, and more. Visit www.wpc-services.com.

For Immediate Release



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