From initial gap analyses through implementation and optimization, Legacy is an experienced provider of electronic data interchange (EDI) consulting and solutions for payor organizations. Legacy gained this experience by helping payors overcome the challenges of HIPAA and the 4010 transaction standard implementation during the past decade. Legacy’s industry-leading solutions, including AdminisTEP, enable organizations to better manage transactions — in any format — and improve first-pass rates while lowering per-transaction costs. Below are highlights of how Legacy can make your organization 5010 enabled.

5010 Gap Analysis
Discover how the 5010 standard will impact your organization and develop a strategy for you to prepare based on a thorough gap analysis performed by Legacy that will:
Inventory systems and trading partners reliant on EDI
Determine modifications and upgrades for systems, and assist with system selection when
replacement is necessary
Develop implementation timetables

Transaction Testing
Pre-production transaction testing from Legacy helps you identify the systems that are ready for the 5010 transition. In addition, creating a transaction testing program for your business partners helps you determine which ones are able to exchange compliant transactions. Legacy’s transaction testing services cover all 40101A and 5010 transaction types (e.g., 837, 835, 270/271, 278, 276/277).

Transaction Translation
Legacy’s AdminisTEP transaction exchange portal enables payors and providers to send and receive transactions in any format, and AdminisTEP handles all of the transaction translation in the background. It’s the perfect solution for payors to 5010 enable their provider networks and add value to business relationships. Also, AdminisTEP is a cost-effective way to extend the functionality of existing adjudication systems by adding enhanced functionality and reporting capabilities.

Companion Guide Development
Many payors expect the 5010 transition to share similarities with first HIPAA transition. This includes the reliance on companion guides to give specific instructions to providers about EDI transactions. Legacy can assist payors with the development of companion guides that will minimize 5010 implementation costs. Additionally, Legacy can help with the creation of “workarounds” that facilitate compliant transactions at a fraction of the cost of traditional implementations.

5010 Optimization
Following initial implementation, partner with Legacy to introduce next-generation functionality into your systems by taking advantage of advanced capabilities within the 5010 transaction standard, such as:
Configuring the 271 eligibility reponse transaction to provide more than just a simple “yes” or
“no” response. Instead, use the transaction to give providers additional patient information,
such as demographics, benefit start/stop dates, and specific eligibility information (e.g., ER
visit eligibility, etc.).
Maximizing the use of the 276/271 claim status inquiry/response transactions to reduce
administrative costs for payors and providers. Leverage the claim ID capability within the 5010
standard to help locate claims more efficiently.
Using the 835 claim remittance advice transaction to help provider reconcile payments —
especially when there is more than one payment per claim.