Consolidated TPA Information

Updated: 12 October 2011

In accordance with 45 CFR Part 162 – Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA); Final Rule, HIPAA-covered entities, which include state Medicaid agencies, must adopt modifications to the HIPAA required standard transactions by January 1, 2012.  The modifications are to the HIPAA named transactions to adopt and implement ASC X12 version 5010 and NCPDP Telecommunication version D.0. 

IPRS will be implementing the HIPAA requirements for the 5010 transactions within the MMIS+ claims processing system.  HP Enterprise Services will notify LMEs through User Alerts as the HIPAA 5010 implementation efforts progress.

In preparation for 5010 testing and implementation, HP Enterprise Services will begin accepting updated Trading Partner Agreement-Appendix A effective July 1, 2011. Follow the attached link to the 5010 version of Appendix A (click here to access form). Complete and mail, with original signature, to HP Enterprise Services – Attn. IPRS. Your completed Trading Partner Agreement-Appendix A will then be forwarded to Medicaid for processing.  You will be e-mailed a letter with instructions on how to proceed with 5010 transaction testing after your Trading Partner Agreement-Appendix A has been processed.

HP - IPRS
2610 Wycliff Rd, Suite 401
Raleigh, NC 27607