About Me

Vice President & Co-Founder of AMBS, Inc. www.AMBSinc.com Greg has been involved with the business services and outsourcing industry for the last 20 years, helping some of the largest Fortune 500 corporations, and small to medium sized healthcare practitioners with their outsourcing needs.

Thursday, March 29, 2012

Have You Completed Your 5010 Implementation?

There are steps to ensure that your upgrade is a smooth one: establish a line of credit and check partner readiness
Recently, the Centers for Medicare & Medicaid Services (CMS) announced it will not initiate enforcement action against any HIPAA covered entity for an additional three (3) months, through June 30, 2012,for the updated HIPAA transaction standards (ASC X12 Version 5010, NCPDP Versions D.0 and 3.0).
Although much progress has been made in the successful receipt and processing of claims in the Version 5010 format, CMS is aware that there are still challenges and issues impeding an industry wide upgrade.
During these additional 90 days in which CMS will not initiate enforcement penalties, you should collaborate more closely with trading partners on appropriate strategies to resolve any remaining problems. Two steps providers can take to ensure a smooth upgrade are:
  1. Establishing a line of credit: To avoid potential cash flow disruptions, providers should consider establishing or increasing a line of credit. By doing so, they can prepare for possible delays and denials in payer claims reimbursements if noncompliant Version 5010 transactions are submitted. 
  2. Check partner readiness: Because a provider's Version 5010 upgrade can be dependent upon his or her vendor, it is important for providers to be aware of their vendor's transition status. If your vendor is behind schedule for Version 5010 adoption, get confirmation of their timeline to be compliant, and encourage them to take action so that your system will be prepared to handle your claims.  
Other steps to prepare for the Version 5010 upgrade can be found on the Version 5010: Ensuring a Smooth Transition Fact Sheet, which provides an overview of several actions providers can take to maintain continuity of operations for their practices as they prepare to complete Version 5010 testing.

Keep Up to Date on Version 5010 and ICD-10.
Please visit the ICD-10 website for the latest news and resources to help you prepare, and to download and share the implementation widget today!

Wednesday, March 14, 2012

HIPAA 5010 Transition Problems


Many Physicians experience problems during 5010 Transition

On January 1, 2012, all electronically submitted HIPAA covered health insurance claims were supposed to be submitted using the 5010 platform.  Although CMS had previously announced it would not take any enforcement action against any plan or provider who was not 5010 ready until after March 1, 2012, the January 1 deadline for compliance remained in effect.
Perhaps the most consistent reports heard during the transition were that the problems – whatever they were – were someone else’s fault.  Clearinghouses blamed Health Plans (both commercial and government) and Health Plans blamed providers, clearinghouses or practice management software programs.  There were so many fingers being pointed at others over the past two months, it is a wonder there wasn’t a major up-tick in the number patients showing up in ERs with broken fingers!