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Frequently Asked Questions
Q: Will my Henry Schein practice management software be 5010 compatible by 2012?
A: Yes. The latest versions of Henry Schein practice management software will be
updated to be 5010 compliant with the most integrated and streamlined process available.
Older versions may have updates to allow for 5010 compliance. See the detailed information
online regarding your specific software.
Q: When will HSPS begin testing 5010 compliance?
A: Testing has already begun between Henry Schein’s eClaims software and its clearinghouse
connections.
Q: What aspects of my Henry Schein practice management software will be impacted
by the 5010 changes?
A: Electronic claim submission and insurance eligibility reporting will be impacted.
Customers using the latest versions of Henry Schein practice management software
and Henry Schein’s eClaims software will be able to submit claims using the most
streamlined and efficient method possible. Customers that are NOT using the latest
versions of Henry Schein practice management software will still be able to submit
claims that are 5010 compliant, but may need to perform extra steps to submit claims.
Submitting electronic claims through Henry Schein practice management software will
continue to be the most efficient method of submitting claims.
Q: What is the difference in the claim submission process between the latest versions
of Henry Schein practice management software and older versions?
A: Customers using the latest versions of Henry Schein practice management software,
as provided in a customer service plan, will benefit from updates to the core software
that minimize the impact of the changes. Additional fields for newly required information
will be added to the core software and extracted automatically in the claim submission
process. Customers using older versions will be required to complete the new fields
manually prior to each claim submission. Customers using third-party claim submission
software will be required to perform additional steps.
Some customers are on versions of HSPS software (Dentrix and Easy Dental) that will
not be compliant with HIPAA 5010 standards. In some cases the non-compliant claims
will be converted to a compliant format. As payors begin to request additional information
with claims, this process will be insufficient. These customers will eventually
need to upgrade to a compliant version of HSPS software and eTrans 3.1 or higher.
Other customers (Dentrix and Easy Dental) that are submitting claims in an outdated
format will need to upgrade immediately to send claims through HSPS. There software
versions will not be HIPAA 5010 compliant and will be incapable of submitting claims.
Those customers will be contacted by HSPS regarding their situation.
Q: Where can I learn more about 5010 and ICD-10?
A: Visit the U.S. Department of Health and Human Services' website at:
www.cms.gov/ICD10/.
Q: How will I get the updates for 5010?
A: Updates will be provided for Henry Schein practice management software and its
eClaims software. Customers are encouraged to be on the latest version of their
practice management software for the most efficient workflow. Customers on compliant
versions will need to install the latest version of eTrans.
Q: When will the updates be available?
A: The eTrans auto-update will be made available in December of 2011. Updates to
core software that provide an even more streamlined claim submission process will
be made available early 2012.
Q: What are some of the things I can do today to prepare for the 5010 changes?
A: Providers can take the following steps today to prepare:
- Every provider address must use a nine-digit ZIP code (ZIP+4).
- For electronic claims, the Billing Provider name and Pay-To provider address (that
appears in the Primary Dental Insurance window) will be sent in the claim and is
where payors will send payment. The Rendering Provider name and Billing Provider
address is also sent in the claim and reflects who performed the services and the
location where services were performed.
- The address for the Billing Provider can no longer be a P.O. Box; it must be the
physical address of the provider where services were rendered. However, the address
for the Pay-To Provider can either be a P.O. Box or physical address. The Pay-To
Provider address should reflect where payors need to send payments (which may be
different from the provider’s address where services were rendered).
- Legacy IDs (such as Medicaid IDs, BCBS IDs and so forth) may no longer be sent in
electronic claim submissions. Correct NPI numbers are required. Your front-office
staff will need to contact insurance payors to verify that they have the correct
NPI numbers in their provider tables.
Q: When will the updates be available?
A: The software update will be available as part of an auto-update to eTrans at
the end of November. New information will be added to the HIPAA 5010 web pages regularly
so providers are aware of changes to payor requirements resulting from the 5010
standards.