As providers and payers face the initial HIPAA 5010 milestone – Level 1 Compliance come January 1, 2011 – many folks charged with instituting the changes are not at all certain of how to endure the transition.

HIPAA 5010 and the enhancements it brings comprise the bedrock of what one industry veteran described as the standardization of medical claims informational content. Yet, by most accounts, providers are making only limited progress with 5010.

“Hopefully HIPAA 5010 is going to be a messiah,” said Bryan Koch, vice president of strategic services at Navicure. “The beginning of this standardization is at hand and the future of continued standardization looks bright.”

[Related Q&A: ICD-10 worst case scenario. See also: McKinsey says ICD-10 among reg's that demand payers rework 90 percent of IT architectures.]

It's worth noting that Koch possesses more than just a vendor's perspective; prior to joining Navicure, in fact, he served as chief operating officer at a 2,500-strong physician medical billing and practice management company. On Tuesday he drew from his experience to share seven tips for surviving the transition during a Webinar titled "HIPAA 5010: Opportunity or Chaos?" Here's that list:

1 Become informed
2 Create a list of vendors that you submit/receive any HIPAA transactions to or from
3 Gather vendor requirements for transitioning to 5010 and test when vendors demand it
4 Prepare staff for 5010 changes and allocate time for necessary testing
5 Test against all payers with whom you work directly
6 Plan for necessary software updates
7 Monitor all aspects of transaction processing during and after the 5010 transition

Navicure also joined the somewhat small chorus of folks singing the virtues of HIPAA 5010 by explaining the benefits as: reduced manual processes, increased electronic transactions, more consistent information, and better claim data filing requirements.

Indeed, CMS (The Centers for Medicare and Medicaid Services) and others are beginning to highlight some of HIPAA 5010's advantages. This month, Renee Lin, a.k.a. Health Plan Geek, shed light on four very welcome HIPAA 5010 changes, and offered a HIPAA 5010 checkup with 10 points to consider. CMS, meanwhile, in June shared its look at seven benefits of HIPAA 5010.

So, with the 5010 deadline looming and ICD-10 quick on its heels, why are so many folks in the dark about 5010's advantages and how to manage the transition? Koch has an idea about that.

“In my experience, most providers, billing managers, billing personnel, practice administrators, just don’t think a lot about how claims are transmitted,” he explained in an e-mail exchange. “They mostly know that their PM and billing systems generate an 'ANSI' file that is then transmitted to the appropriate insurance payer or clearinghouse, but I do not think that most of them have the time to strategically think about how all of these changes will impact their practices.”

Whether you've begun or not, are you considering the potential strategic impacts of HIPAA 5010? Let us and other readers know by commenting below.

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