Can someone explain HIPAA 5010?

**Striderswife** · 12-29-2011, 01:23 PM

Our office is not a provider for any insurances, so sometimes we hear about things a little late. We do file on behalf of some of our patients (and all Medicare patients, even though we're non-assigned), and we've received notification that we have to upgrade our electronic data interchange blah blah blah. Apparently, if we're not compliant with the new regulations as of January 1, 2012, we will be in violation, and have until March 31 before enforcement action takes place. Maybe it's not as scary as it sounds, but it's a little nerve-wracking.

Can anyone explain what is going on, and what we need to do? We've got a call in to OfficeMate, but are waiting on a return call. I thought I'd throw this out there and see if anyone can give us some direction.

Thanks!!!

**rbaker** · 12-29-2011, 02:30 PM

Not to be a smart **** but Google "HIPAA 5010" for more information than you will ever want or need.

**Striderswife** · 12-29-2011, 02:57 PM

Thanks for not being smart (smartypants

), but we've read what OfficeMate and Zirmed (our insurance intermediary) have to say, and it's just an overload. I was hoping to hear in English from someone who has already dealt with this--what it means and why we have to do it. I like to be able to come hear and pick the brains of my colleagues and feel like I've got some personal resources. That's all.

**chip anderson** · 12-29-2011, 04:16 PM

Actually all HIPAA is BS as far as eyeglasses and eyeglass Rx are concerned. Now if it had to do with something that could ruin ones social status like a record of treatment for HIV or syphlis then there would be a great need for confidentiallity.

But disclosing someones eyeglass Rx, big deal.

Chip

**bigeyejim** · 12-29-2011, 05:18 PM

Here is a link (I hope it works) to Gateway EDI, our clearinghouse. Our software does the update for us, and all we had to do was bill with our 9-digit zip code (zip+4). We have been up and running for several months now, with no rejections. As long as your Office Mate is up to date, and has been tested by your clearing house, you should be alright. Might be quicker to talk to clearing house verses OM.

Cheers.

OOOOPPPPSSSSS....

http://www.gatewayedi.com/5010/news/#post-8484

**Striderswife** · 12-29-2011, 08:59 PM

Thanks, bigeyejim. We've had some communication with Officemate, and it's going to (eventually) work out. We're going to suspend some of our claims (we always do this with Medicare, anyway, until the new tables come out for the year), and give the other patients the option of mailing their own claim forms to their insurance. We'll still print them out, but we're not going to raise our stamp budget for insurances we don't even file. . .

Chip, I totally agree with you on the HIPAA/eyeglasses thing. And even the care between two doctors doesn't require a release anymore, but so many offices don't know it yet. I called an office today to get a pt's last Rx, simply to have some kind of background (she didn't bring her glasses), and the gal was kind of snippy with me, asking me to have the patient sign the "Oklahoma Privacy Policy release form" (which is baloney) and she'd go dig it up for us. We weren't going to make glasses off it, and we weren't even asking for her complete record, just the Rx! I think our doc decided we can do the exam just fine without it. But yeah, I've always agreed with your sentiment of "big deal." As far as insurance is concerned, glasses are a vision matter, not a medical one. So, there.

**eyechick1969** · 12-30-2011, 04:33 PM

Hey, if the woman's eyes were 'good enough' that she could drive in/come in without specs, an eyeglass history Rx was of probably no importance.

totally, haha!! A few years back a number of docs started requiring a signed release form for spectacles rxs. I think hoping to make it easier to go back there for specs than go back there, sign a release form, wait for it to arrive at the other place, etc.......

Hippa & eyeglass rxs just don't make sense to me personally, but I guess that's a matter of opinion.

Many, many years ago I had a client who didn't like that we called his office & said his contacts were in. So since, I've learned to just say their order is in. (but that was an extreme case)