H2H 4010/5010/ Test Data Creation Tool (TDCT)

H2H Solutions is currently engaged in the development of a data conversion tool to facilitate the implementation of the soon to be required 5010 HIPAA format changes. Government mandates relative to changing content and format requirements for a wide array of health care transactions have occurred periodically over the years, and will certainly continue into the future. Coping with these changes can be painful for payers, particularly as they relate to changes in claim formats. Payers will be required to adhere to strict payment schedule expectations from Physicians, Hospitals, etc., even though the Payer may not have received any of the newly formatted claims in the past. Once Physicians begin submitting the new 5010 format claims, they will not tolerate delays in receiving their payments, and they expect all Payers that they deal with to be prepared to process them without delay.

H2H has developed a comprehensive tool set that will afford Payers throughout the country the ability to insure that their adjudication systems are prepared for this onslaught. The H2H 4010/5010 Test Data Creation Tool (TDCT) is designed to perform two global functions. First is the data conversion and creation aspect that will automatically convert existing HIPAA transactions from their current 4010 formats – directly to the new 5010 formats, thereby allowing the Payer to evaluate the ability of their adjudication platform to process the new format, and to determine exactly where changes will need to be made. Secondly, the TDCT provides for a reverse process whereby the 5010 transactions can be exported back to the older 4010 format; all of which can be facilitated by either entering data into online screens, or thorough a batch uploading of data files.

The TDCT tool set will position any payer to evaluate a wide array of attributes in its adjudication platform, prior to the first 5010 transaction coming through the door, thereby better preparing the payer to accurately process these transactions when they begin arriving in volume. The TDCT will support batch testing of HIPAA 5010 and ICD-10 compliance solutions, and will also provide data entry screens that “Business” will appreciate for evaluating group specific “one-of” benefit plan design / testing scenarios.

The TDCT tool will support ALL HIPAA mandated transactions, and can be presented via a web cast at your convenience.