• Four months left to ensure 5010 compliance: Are you ready to test?

    We're entering the last month of summer and no doubt that means a plenty of students being rushed in for their school physicals and any necessary vaccinations. Before long, the students will be back in class and worrying about their next test. But they are not the only ones with tests to take. Your practice management or claims submission software vendor is being tested to ensure compliance with the 5010 HIPAA-compliant electronic transaction standards, and the Centers for Medicare & Medicaid Services (CMS) requires that they pass!

    That is why CMS has announced a National 5010 Testing Week for Aug. 22 through Aug. 26. Practices whose software vendors have completed the necessary upgrades may take advantage of an opportunity to come together and test their work with the added benefit of real-time help desk support and direct and immediate access to the Medicare Administrative Contractors (MACs). This is a great opportunity to complete testing of the new transactions and move to production not only before the Jan. 1, 2012 compliance deadline but also before your practice must complete end-of-year tasks such as annual code updates and Medicare benefit changes for 2012.

    If your software vendor or clearinghouse is handling the testing for you, be sure that you are aware of their progress and expected date of completion. The MACs will process both the current 4010 transactions and the 5010 transactions of those practices that have successfully tested. However, CMS has emphatically stated that on Jan. 1, 2012, only transactions in the 5010 format will be accepted. If you or your vendor have questions about testing or the formats for addresses or other claims fields, you can contact the Medicare Part B EDI helpline for assistance.

    Don't let your claims submissions get an "F" on January 1st!

    Posted on Aug 02, 2011 by Cindy Hughes

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.