HIPAA 5010

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Henry Schein Practice Solutions and HIPAA

Strengthening the Security of Patient Personal Health Information


Henry Schein Practice Solutions (HSPS) has reviewed the HIPAA privacy, security and electronic data interchange regulations and continues to evaluate related additional legal requirements to ensure timely compliance of HSPS's systems and procedures with applicable HIPAA requirements, including those added as a result of the HITECH Act enacted in 2009.

Additionally, we will continue to provide our customers with significant product and service upgrades and enhancements, many of which will assist our customers in their own HIPAA compliance efforts. Please note that the various HIPAA standards require our customers to address internal policies and procedures and change their practices in ways that extend beyond the scope of our products and services; it is not possible for us or any other software package to make customers "HIPAA-compliant."

Click here to learn more about how HIPAA 5010 compliance
affects your practice and what you can do to prepare.

While we will continue to provide our customers with product upgrades and information that will assist customers in their individual HIPAA compliance plans, we also strongly encourage our customers to become familiar with all HIPAA requirements and how these impact their own respective practices.

HIPAA 5010 and ICD-10

As part of the HIPAA EDI rules, healthcare providers must be fully compliant with the new HIPAA 5010 electronic transaction requirements by March 31, 2012. The 5010 update also accommodates the introduction of the ICD-10 code set, which must be used for medical diagnosis and inpatient procedures beginning October 1, 2013. While that deadline may seem far away, it’s quickly becoming a concern for providers who are hearing more and more about the update.

The HIPAA 5010 update replaces the existing 4010/4010A requirements for EDI. In the 5010 update, many of the changes occur in the electronic transmission of data, and will be unnoticeable to our customers. The most obvious impact of the 5010 requirements will be in the format and codes for submission of electronic claims to payors. Once the changes take effect, each claim will require information that was not included previously.

We will continue to keep you posted with the latest information regarding product and service updates related to HIPAA 5010 and ICD-10 implementation.

Your current claim submission process is compliant and you do not need to make any immediate changes as a result of 5010. As insurance carriers begin to require additional claim information as part of the HIPAA 5010 standards, you may be required to perform a software update. You will be notified in advance if an update is required.

To download the latest eTrans update, select your version from the list below.

Dentrix Enterprise 6.0
eTrans User Guide

Your current claim submission process is compliant and you do not need to make any immediate changes as a result of 5010. As insurance carriers begin to require additional claim information as part of the HIPAA 5010 standards, you may be required to perform a software update. You will be notified in advance if an update is required.

To download the latest eTrans update, select your version from the list below.

Dentrix Enterprise 4.0 and 5.0
eTrans User Guide

Privacy and Security

HSPS has reviewed and implemented policies and processes based on the privacy and security standards outlined in HIPAA and HITECH, including regulations issued by the U.S. Department of Health and Human Services (HHS) and HSPS believes it is compliant with those of the standards and rules for which compliance is currently required.

Electronic Data Interchange (EDI) Services

Federal regulations adopted under HIPAA also establish "Standard Transactions and Code Sets" for the sharing of certain data by electronic means between and among health care providers and third party payors, such as health insurers. These standards for data elements, code sets and formats are to be used to conduct certain electronic health care transactions. Those transactions that are covered by these EDI rules are defined by HHS, such as claims submitted by a health care provider to patients’ health insurers via electronic media, and other routine transmissions of health care data to carry out certain financial or administrative activities related to health care (such as eligibility inquiries).

HSPS has undertaken an extensive review and inventory of its products and services to verify those that are within the scope of the HIPAA EDI definitions. We have developed policies and procedures so that HSPS is capable of conducting covered electronic transactions with respect to our eServices products using the mandated standards and codes.

Payor News
  • All Payors

    HIPAA requires at least one address on all claims to contact a street address. Read more

    Medicaid of Florida

    Claims must be submitted with only an NPI in the billing. Read more
  • Medicaid of Iowa

    US addresses must include the full nine-digit zip code. Read more

    Medicaid of Delaware

    Providers are required to submit annual Provider Disclosure Statement. Read more
  • Medicaid of New York

    Provider zip codes must be zip+4 on electronic claims. Read more

    Medicaid of Nebraska

    Providers are required to
    re-enroll for EDI claims.
    Read more
  • Medicaid of Oregon

    Providers are required to
    re-enroll for EDI claims.
    Read more


    Medicaid of Montana

    Claims must contain NPI, Taxonomy and Zip +4.
    Read more
  • Medicaid of Oklahoma

    Provider zip codes must be zip+4
    Read more


    Medicaid of Utah

    Providers must verify their
    NPI has been registered by
    contacting Provider Enrollment Read more