The Health Insurance Portability and Accountability Act (HIPAA) mandated that all healthcare clearing houses, healthcare providers, and health plans must comply with new electronic transaction standards, which is version 5010. Moving away from the 4010 format, HIPAA 5010 which went into effect from Jan 1, 2012, makes sure that healthcare transactions can ably support new and dynamic developments in healthcare management like ICD- 10 code set changes, etc.

HIPAA requires healthcare entities that conduct specific healthcare transactions like electronic claim submissions, remittance advice, claim status inquiry, payments to providers, eligibility/benefits requests, referral requests and responses, health plan enrollment and disenrollment, benefit and premium payment coordination, and responses and claim remittances to use Version 5010.