HHS opened rulemaking on the next EDI standards migration in 2025. There is no deadline yet, but the last transition (4010 to 5010) touched every PM system in the market. Here is what to plan for.
August 11, 2026
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HHS opened rulemaking on the next EDI standards migration in 2025. There is no deadline yet, but the last transition (4010 to 5010) touched every PM system in the market. Here is what to plan for.
Portal-based claim submission works for a handful of payers. It breaks around payer 15 to 20. Here is what real multi-payer submission requires, and when platforms outgrow the portal approach.
Every PM and EHR platform eventually faces the build vs buy decision on payer connectivity. Here is a framework for evaluating both paths, including the hidden costs vendors rarely price in.