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Blue Cross and Blue Shield of Florida HIPAA 5010 Readiness, Transition and Status (“Open-Line Friday”) “A discussion with external trading partners; senders.

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Presentation on theme: "Blue Cross and Blue Shield of Florida HIPAA 5010 Readiness, Transition and Status (“Open-Line Friday”) “A discussion with external trading partners; senders."— Presentation transcript:

1 Blue Cross and Blue Shield of Florida HIPAA 5010 Readiness, Transition and Status (“Open-Line Friday”) “A discussion with external trading partners; senders and providers” November 18, :30am-10:30am EST Conference ID: Passcode:

2 2 Agenda Introductions and Bridging (“A few administrative details!”) BCBSF’s HIPAA 5010 Status Update (“Where are we?”) –Transition Metrics To-Date (“How are we doing?”) –Production Validation Process (“An update”) 5010 BCBSF: A Consolidated View of Where We Are (“Special Topic”) Q&A (“Open Line”) Key Contacts Blue Cross and Blue Shield of Florida HIPAA 5010 Readiness, Transition and Status (“Open Line Friday”)

3 Introductions and Bridging (“A few administrative details!”) Introductions and a few administrative details: Please send an message to with your contact information if you are on this call. Please use our address for any feedback on the value of these sessions; future topics or questions you may have. Bridging: The federally mandated compliance date for HIPAA 5010 is January 1, All standard covered HIPAA electronic transactions are changing. Overall health care industry 5010 transition metrics are below expectations. BCBSF’s “Open Line Friday” teleconference calls began on October 14, 2011: Measurably increase the transition to 5010 through collaboration, sharing experiences and understanding our challenges. Provide a regularly scheduled forum for 5010 dialogue with our external trading partners; senders and providers. To recognize the value of collaboration and cooperation as we take the final steps toward compliance with 5010.

4 Current HIPAA 5010 Status Update (“How are we doing?”) HIPAA Standard Electronic Transaction BCBSF 5010 Go-Live Date Transition Metric (through 11/16/11) Transition Metric (through 11/09/11) Claims (837I/P)April % (208/2300+ senders) 32% (181/2300+ senders) Remittance (835)April % (35/1309 receivers) 2% (30/1309 receivers) Eligibility & Benefits (270/271) August % (18/47 vendors sites) 49% (18/47 vendors sites) Claims Status (276/277)Sept % (7/12 senders) 27% (7/12 senders) Medical Clearance (278)Nov 20110% Enrollment (834)October, %

5 Things To Remember About Our PVP: The PVP Process is not a TEST; it is a controlled production migration activity that is designed to validate 5010 readiness between trading partners using live- production data. To get engaged in the PVP Process, you must: be a direct business-to-business or EDI submitter of any covered HIPAA electronic transaction; and you will need to schedule your 5010 file submission by contacting Keith ( ). Some New Success Stories …. Production Validation Process (PVP) Update

6 BCBSF: A Consolidated View of Where We Are Initial Open-Line Friday Pilot Sessions (October 14 th and 21 st ) Transitioning to 5010 In-house FAQ’s Identifying A Provider in 5010: The NPI Challenge (October 28 th ) NPI Rules of Engagement Defining the NPI Challenge BCBSF’s Approach to Addressing the NPI One-to-Many Challenge What I Need To Know and What I Need To Do Now (November 4 th ) Production Validation Process (“A Practical How-To Guide”) Key Next Steps for a Provider/Electronic Transaction Trading Partner Business Continuity and What I Need To Know (November 11 th ) Key Next Steps in Building a Successful Business Continuity Plan A Consolidated View of Where We Are (November 18 th ) In-house FAQ’s

7 Still Need More Information? The following publically available Websites are excellent resources for 5010 information (a few examples follow): Some Helpful Sources of 5010 Information

8 Questions? Next Session will be held on December 2, 2011 Suggested “Special Topic”: “5010 BCBSF: The 30 Day Countdown Begins”

9 Key Contacts Paul Decrosta Keith Hatch (for PVP) George Vancore Next Session: Friday, December 2, 2011 Same Time/Same Call-in Numbers Thanks! 9


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