Frequently Asked Questions

What is "5010"

"5010" refers to the new national electronic transaction standards, known as X12 Version 5010 (5010) and NCPDP version D.0 (D.0). The U.S. Congress mandated that the Center for Medicare and Medicaid Services (CMS), an office of the Department of Health and Human Services, adopt standards for the electronic submission of medical service claims. In January 2009 CMS announced that providers would be required to submit claims to Medicare and Medicaid according to new HIPAA X12 5010 standards. Go to http://www.cms.gov for more information about the new electronic transaction standards.

Is DHSS compliant with the 5010 electronic transaction standards?

Yes. DHSS is compliant with the new national electronic transaction standards, known as X12 Version 5010 (5010) effective as of January 1, 2012. Alaska-specific HIPAA 5010 Transaction Companion Guides with the information necessary to populate transactions with codes for processing claims, eligibility status requests, claim status requests and requests for service authorizations are available at http://www.medicaidalaska.com/providers/hipaa/hipaa5010_news.shtml. Trading partners can learn more about 5010 syntactical testing, test their capability to provide clean 5010 transactions, and be certified for HIPAA 5010 on the state’s Fiscal Agent website:http://www.medicaidalaska.com.