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Learn About Governor Brewer's Medicaid Plan for Arizona

HIPAA 5010 Consortiums and Documentation

5010

The AHCCCS HIPAA 5010 project is now concluded. Please refer to the EDI Technical Documents web page for current Companion Guides. http://www.azahcccs.gov/commercial/EDIresources/EDITechnicalDocuments.aspx

Please refer to the Technical Workgroups & ICD 10 Consortiums and Documentation for current meeting information.
http://www.azahcccs.gov/commercial/EDIresources/ICD10.aspx

At the current time, information on this page will be maintained as reference.

The HIPAA 5010 electronic file formats replacde the previous 4010a electronic file formats (with few exceptions) as the most current version of federally mandated HIPAA transactions, and were required to be implemented for processing no later than January 1, 2012.

5010 Companion Documents, Testing Overviews and related documentation are posted to the Webpage as available and as updates occur.

5010 FAQ's

Note: Information provided in PDF files, unless otherwise shown.

HIPAA Provider/Clearinghouse 5010 Initiative Related Information
Date	Documents
01/08/13	AHCCCS CORE Rules Ph1 and Ph2 Notice 276 277 Claims Status [21KB]
12/31/12	AHCCCS CORE Rules Ph1 and Ph2 Notice 270 271 Eligibility [36KB]
6/26/12	Notice for 824 version change in Test Region [12KB]
5/18/12	AZ 5010 835 Testing Overview [40KB]
5/16/12	Difference in 824 005010X186 [20KB]
8/22/11	837 5010 Testing Calendar Claims v2011-08-19 [76KB] 837 5010 Testing Overview Claims v2011-08-19 [45KB]
7/19/11	270/271 Testing is open to all Trading Partners [18KB]
6/29/11	270-271 5010 Testing Calendar v2011-06-22 [79KB] 270-271 5010 Testing Overview batch v2011-06-22 [44KB] 276-277 5010 Testing Calendar v2011-06-22 [80KB] 276-277 5010 Testing Overview Batch v2011-06-22 [42KB]
5/17/11	276/277 Testing is Open to all Trading Partners [10KB]
3/23/11	Transaction Acknowledgements [32KB]

Information for scheduled Contractor Consortium Meetings, such as agendas, minutes and issues, and action items and updates is provided below; as are any other relevant updates or documentation related to AHCCCS’ implementation of this initiative.

HIPAA Health Plan/Program Contractor 5010 Consortium Meeting Documents and Other Initiative Related Information
Date	Documents
10/1/12	BHS Plans - Approved Amount Matrix v20120928 [35KB] Non-BHS Plans - Approved Amount Matrix v20120928 [42KB]
9/25/12	Other Payer paid more than HP Allowed [17KB]
6/26/12	Notice for 824 version change in Test region [15KB]
5/29/12	837 v5010 Encounter File Size Limitation [9KB]
5/16/12	Difference in 824 005010X186 [20KB]
5/9/12	837 v5010 Encounters Companion Guide-Instruction Table Corrections [43KB]
4/18/12	Community Manager Issue #12724 [10KB]
1/31/12	Consortium Agenda [16KB] 5010 status 1-31-12 [38KB] Attachments for Encounter Updates 01 31 12 [262KB] DV OMISSIONS REMINDERS [194KB] DV Removal guidelines [18KB] Encounter Updates for consortium 01 31 12 doc C [41KB] FeeStakeholderMemo [30KB] FW 340B FQHC FQHC Look-Alike Pharmacy List [206KB] FW 340B Payment Methodology - Memo [460KB] ICD10 status 1-31-12 [18KB] RE Reminder - Changes to 5010 834 for Behavioral Health Active Care Designation [6KB] Updated DRAFT Copays Matrix [93KB]
12/28/11	12/7/2011 Technical Consortium Meeting Minutes [77KB]
12/7/11	Consortium Agenda [18KB] 5010 Status 12-11 [28KB] 340B Pricing Flow 11-28 [40KB] ICD-10 Overview 12-11 [43KB] Update RE Changes to 5010 834 for Behavioral Health Active Care Designation [16KB]
8/23/11	8-23-11 Technical Consortium Meeting Minutes [67KB]
8/22/11	837 5010 Testing Calendar Encounters v2011-08-19 [76KB] 837 5010 Testing Overview Encounters v2011-08-19 [45KB]
8/22/11	Consortium Agenda [18KB] 5010 Transaction Timelines - Revisions as of 8/23/2011 [8KB] 5010 Technical/System Updates 8/11/2011 [21KB] Benefit Redesign Implementation System 8/3/2011 [19KB] Benefits Q&A 8/23/2011 [29KB] Change to Health Plan Reference Extracts - 8/13/2011 [12KB] Facility Peer Groups 8/8/2011 [67KB] OPFS Multiple Surgery Scenarios - 10/1/2011 [26KB] Other Project Q&A - 8/23/2011 [28KB] Outpatient Hospital Capped Fee Schedule ENCOUNTERS [55KB]
7/19/11	7-19-11 Technical Consortium Meeting Minutes [67KB]
7/15/11	Consortium Agenda [18KB] 5010 Transaction Timelines - Revisions as of 7/14/2011 [7KB] 5010 Transaction Timelines - Revisions as of 6/17/2011 [14KB] 5010 Technical/System Updates [21KB] Benefit Limitations - Systems Impact Matrix DRAFT [13KB] Benefits Q&A [21KB] Health Plan Milestones Checklist [60KB] Medicaid NCCI & MUEs Overview [18KB] Multiple Surgery Logic Update [12KB] OPFS Key Changes for 10/1/2011 [13KB] OPFS Scenarios - 10/1/2011 [26KB] Reminder - 5010 834 Updates effective 10/1/2011 [8KB] ICD10 Timeline [8.46KB] Status Code B Update [16KB] Outpatient Hospital Capped Fee Pricing Decision Tree [55KB] Data Validation - Contractor Notice July 2011 [21KB]
5/17/11	Minutes for the April 19, 2011 AHCCCS Technical Consortium [66KB]
4/19/11	Consortium Agenda [23KB] 5010 Partial Implementation [27KB] 5010 834 Changes for 10 [11KB] 5010 Encounters Processing [17KB] 5010 Implementation Plan Timeline [16KB] 5010 Implementation plan updated 4-8-2011 [18KB] Acknowledgements v2 2 2011 03 [39KB] Crib notes example [12KB] High level Overview of Key changes associated with OPFS [13KB] Medicaid CCI and MUEs overview [19KB] Overview MSR [11KB] Overview Status Code B [19KB] Side by Side Draft [109KB] Webpage Overview [85KB]
3/23/11	Transaction Acknowledgements
11/30/10	Consortium Agenda [14KB] Systems Updates Consortium 11/30/10 [42KB]
8/23/10	AHCCCS HIPAA 5010 820 Transaction Testing Overview, Rev. 2 – 8/23/10
8/2/10	AZ 820 Sanction Example (corrected 8/2/10) [68KB]
7/27/10	Arizona 5010 834 Block Disenroll V1.2 [38KB] Arizona 5010 834 Block Enroll V1.0 [49KB] Arizona 5010 834 COB Change V1.3 [42KB] Arizona 5010 834 Disenroll V1.3 [38KB] Arizona 5010 834 New Enroll [Add] with COB V1.3 [52KB]
7/26/10	AHCCCS HIPAA 5010 820 Transaction Testing Overview [40KB] AHCCCS HIPAA 5010 820 Transaction Testing Calendar [56KB] AHCCCS HIPAA 5010 834 Transaction Testing Overview [40KB] AHCCCS HIPAA 5010 834 Transaction Testing Calendar [56KB]
7/15/10	Consortium Agenda [20KB] AHCCCS Technical Consortium Meeting Minutes 07-15-10 [54KB] Lori Petre Memo - 7/9/10 [24KB] Revised Timelines [Excel, 42KB] Benefit Redesign Implementation System Considerations [Zip, 237KB] Co-pay System Changes [38KB] Combined Co-pay Service Definitions [11KB] 820 5010 Testing Calendar - Revision 1 [34KB] 834 5010 Testing Calendar - Revision 1 [34KB] 5010 820 Transaction Testing Overview [25KB] 5010 834 Transaction Testing Overview [26KB] Draft 5010 834-820 Companion Document [720KB] Emergency Change Request for the 837I [52KB] 5010 Transactions with Associated Addendum and Errata [87KB]
5/23/10	Consortium Agenda [10KB] AHCCCS Technical Consortium Meeting Minutes 05-25-10 [51KB] 5010 Health Plan Milestones [170KB] AHCCCS Co-payment Requirements in Proposed Rule R9-22-711 [27KB] Benefit Redesign Implement System Considerations Plans 5-19 [26KB] Combined Co-pay Service Definitions [8KB] Revised Timelines 4-19 Plans [14KB] X12N Actual 005010 TR3 Errata Status Report [9KB]
3/18/10	834 AZ Transaction Changes Overview Revised 3/18/10 [39KB] 834 Transaction Examples Revised 3/18/10 [Zip, 207KB] Version 5010 HIPAA Upgrade Presentation - 7/30/07 [193KB]
2/11/10	5010 Electronic Claims (275) Consortium Meeting Minutes [45KB] 5010 Electronic Claims (275) Consortium Agenda [16KB] 5010 Electronic Claims (275) Overview (slideshow) [1.53MB] 5010 (275) Glossary [19KB]
1/14/10	5010 834 Consortium Meeting Minutes [40KB] 5010 Project Consortium Meeting Agenda [17KB] 834 Requirements Walkthrough (slideshow) [273KB] 834 AZ Transaction Changes Overview [41KB] 834 Transaction Examples [Zip, 267KB]
12/09/09	5010 834 Consortium Meeting Minutes [36KB] 5010/ICD 10 Agenda [15KB] 5010 Transactions Overview [68KB] 834 4010-5010 Comparison [179KB] 4010-5010 Image [186KB] AHCCCS Fee-For-Service Provider List Serve [261KB]
10/29/09	5010/ICD 10 Minutes [56KB] 5010/ICD 10 Agenda [15KB] Standards Updates [483KB] 820 5010 Issues List [18KB] 820.4010-5010 Side-by-Side [367KB] 5010 Transactions Overview [50KB] AZ820 v5010 Empty 820 Example [33KB] AZ820 v5010 Normal Detail Example & Voucher Date [55KB] AZ820 v5010 Sanction Adjustment Example & Voucher Date [62KB]
9/9/2009	5010 Timelines (File Formats/Versions - HIPAA Transactions) [34KB]
2/11/2009	5010/ICD 10 Minutes [33KB] 5010/ICD 10 Agenda [9KB] ICD 10 Overview [18KB] ICD 10 High-Level Slides [33KB]
1/07/2009	5010/ICD 10 Minutes [43KB] 5010/ICD 10 Agenda [18KB] 4010 - 5010 Capitation [31KB] 4010 - 5010 Enrollment [66KB] Professional Claim 4010A1 - 5010 [450KB] Transaction Modifications Overview [20KB]

Suggestions or Comments

You are invited to provide suggestions for agenda items for future meetings and to provide comments following review of newly published meeting minutes.

For EDI inquiries, roster issues, or to become an AHCCCS Trading Partner, please email us at: EDICustomerSupport@azahcccs.gov