The 6020 might be going to be replaced by 7030 from the ASC X12 Insurance Subcommittee. This means more changes coming up for vendors to ensure all new changes are implemented for a hassle free billing and reimbursement cycle. Complete paper - www.nalashaa.com/healthcare-it/resources

1. FUTURE OF HEALTHCARE EDI
A brief overview of what lies ahead after 5010
July 2017

2. 2
INTRODUCTION
The Accredited Standards Committee X12
(ASC X12) has continuously worked to-
wards updating the EDIs as a part of their
normal development standards. These up-
dates shall be implemented into common
use only after the Department of Health
and Human Services (HHS) adopts them as
the Health Insurance Portability and Ac-
countability Act of 1996 (HIPAA) standard
through regulation. The Version 5010 was
once such last adaptation from HIPAA
which is currently still in use.
The ASC X12 Insurance Subcommittee
(ASC X12N) transactions was working on a
subsequent Version 006020 (‘6020’). This
version was developed and released for
public comment, but was not brought for-
ward for adoption under HIPAA. ASC X12N
is currently working on the next version of
transactions which is 7030. Version 6020
will be the starting point for the 7030 ver-
sion and will be updated to reflect new
requirements for transactions.
WHAT HAPPENED TO 6020?
ASC X12 Insurance Subcommittee created
the 6020 Guides and Emdeon (now
Change Healthcare) executed a pilot pro-
gram in September 2013. During the pilot,
Critical errors were found in the TR3s and
Change Requests were submitted to ASC
X12. The nature of these observations was
critical enough to discourage the publica-
tion of these. As a result, an attempt has
been made to plug those deficiencies in
the new version.
This is 7030.
WELCOME TO 7030!
The ASC X12 Insurance Subcommittee is
currently working on the HIPAA-adopted
transactions sets 7030, and its in the public
comment period with 4 Cycles completed
as of July 2017 and Cycles 5 & 6 are
scheduled between September through
November 2017.
The public comment periods for the TR3s
(Type 3 Technical Reports) are being sort-
ed in 8 staggered cycles, each cycle has a
set of EDI transactions that are run for the
public comment period between a given
timeframe. In the following page, is one
such example of the Cycle 4 comment pe-
riod between Feb to June 2017.
Future of Healthcare EDI

3. 3
Cycle 4: February 1 - June 1, 2017
Health Care Claim: Professional (837P)
Health Care Claim: Institutional (837I)
Health Care Claim: Dental (837D)
Health Care Service: Data Reporting (837R)
Furthermore on the right is the figure depicting
how the comment period has been planned for
the 7030.
There has been a significant update on
the original scheduled comment period
and there could be more changes on
these timelines.
Future of Healthcare EDI

4. 4
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