5010 Tools & Updates

Tools

Only submitters who send directly to Arkansas Blue Cross and Blue Shield need to complete the forms listed below. If you are using a clearinghouse or vendor to submit claims, the clearinghouse or vendor is expected to test on your behalf.

5010 Testing

Before a submitter can begin 5010 testing they must complete the following 5010 Contact Information form below.

• 5010 Contact Information — Contact information for the submitters/vendors who will be transmitting 5010 test files.
• Testing Criteria for Version 5010 — Criteria for testing the new 5010 transactions.
• Companion Guide (PDF) — Information to provide guidance to trading partners who will be exchanging electronic data.
• Frequently Asked Questions (PDF) — Will assist trading partners with their questions regarding the 5010 migration.

5010 Production Request

After successful testing has been completed, the Move to Production for Private Business form must be completed before sending production claim files. If you are submitting Private Business claims (Arkansas Blue Cross Blue Shield, Health Advantage, BlueAdvantage, Federal Blue Cross (FEP)), only one Move to Production form is required. However, if you also submit Medicare claims, you must complete a separate Move to Production for Medicare form.

•  5010 - Move to Production for Private Business - Complete this form when you are ready to move into production for private business 5010 transactions. If this form is not received your files will be processed as test.
•  If you submit Medicare claims and you are ready to move to production, please complete the 5010 – Move to Production for Medicare form.

Other helpful links for providers:

http://www.wpc-edi.com/content/view/711/401/ - Washington Publishing Company Health Care Code Sets
http://www.cms.gov/versions5010andd0/ - Central Version 005010 and D.0 webpage on CMS website