ODJFS Online | Ohio Medicaid

Job & Family Services Ohio Medicaid

HIPAA 5010 Information

HIPAA 5010 Implementation

On January 1, 2012, ODJFS began accepting Version 5010 files. ODJFS will continue to work with trading partners and providers to achieve a successful transition from 4010 to 5010 by March 31, 2012.

New information is being added regularly so check back often.

Letters from Medicaid Director

11/7/2011 - Urgent Notice About HIPAA X12 Version 5010 Implementation
9/1/2011 - HIPAA 5010 Coming January 1, 2012

Information Releases

5/3/2012 - Update to Medicaid Crossover Claims
3/5/2012 - Completing the Transition from 4010 to 5010
2/6/2012 - Completion of Transition to 5010
1/9/2012 - ICD-10 Readiness
12/16/2011 - December Reminder
12/1/2011 - December Information Release
11/1/2011 - November Information Release
9/30/2011 - 5010 Testing Begins 10/18
9/6/2011 - HIPAA 4010 Cutoff

General Information

11/10/2011 - 5010 Implementation Overview
9/15/2011 - 5010 Testing Notice
02/06/2012 - FAQ
11/1/2011 - FAQ

Companion Guides

270 - Eligibility, Coverage or Benefit Inquiry
271 - Health Care Claim Eligibility Benefit Response
276 - Claim Status Request
277 - Claim Status Response
277U - Unsolicited Claim/Encounter Status Notifications
820 - Payroll Deducted and Other Group Premium Payment for Insurance Product
824 - Application Advice
834 - Benefit Enrollment and Maintenance
835 - Health Care Claim Payment/Advice
837D - Encounter Dental Claim
837D - Fee For Service Dental Claim
837I - Encounter Institutional Claims
837I - Fee For Service Institutional Claim
837P - Encounter Professional Claim
837P - Fee For Service Professional Claims
NCPDP D.0 - Pharmacy Encounter

Additional Resources

Archived Information: http://jfs.ohio.gov/OHP/tradingpartners/archive.stm
CMS web page: http://www.cms.gov/Versions5010andD0/
Washington Publishing: http://www.wpc-edi.com/products/codelists/alertservice