 What Could Happen if You Are Not 5010 Compliant ICD10 Watch has a great article HERE of the possible pains your practice could feel if you are not 5010 compliant by the start date of June 30th, 2012. Some of these include; - Increase of claim rejection
- Delay in Payment
- Possible Financial penalties from CMS
The Center for Medicare and Medicaid Services (CMS) has pushed back the enforcement date for version 5010 until June 30th, 2012. This was a result of push-back from various healthcare provider advocacy groups on CMS. The decision to delay enforcement has given all providers additional time to update their systems and train their staffs. Are you andBilling Dynamix ready for the change? Yes we are!
5010 Growing Pains? The Network Effect is the Cure!
A Story
In December 2011 a provider was receiving reimbursements without issue using 5010 guidelines. In January 2012 these same claims were now getting denied. Our team realized that something had changed with CMS enrollments. We also realized that this concern had a potential to affect other providers as well.
The Network Effect of shared learning allowed our team to address your concern, behind the scenes, before it became a problem for YOU!
What It Is
Version 5010 refers to the revised set of HIPAA electronic transaction standards adopted to replace the current Version 4010/4010A standards. Every standard has been updated, from claims to eligibility to referral authorizations.
All HIPAA covered entities must transition to Version 5010 by June 30th, 2012. Any electronic transaction for which a standard has been adopted must be submitted using Version 5010 on or after June 30th, 2012. Electronic transactions that do not use Version 5010 are not compliant with HIPAA and will be rejected. Some ways that 5010 may help you improve your business include; 1. More appropriate contracting 2. More precise payment 3. Better definition of severity, risk, and case mix 4. Better network management 5. Improved measurement of quality and efficiency. What has Billing Dynamix Done to Protect You?  Starting in early 2011 we applied for all of the necessary certifications, with 1,000's of Payers nationwide, to ensure that we would be 5010 compliant by the original enforcement date (January 1st, 2012). These certifications were completed and we were submitting claims under 5010 guidelines by November 2011. By the time the certifications were completed the enforcement date had already been pushed back to March 31st, 2012. We were up and running a full 5 months before the "new" enforcement date! We are also continually running tests on our system to insure that any changes that occur between now and the start date are correctly implemented for your Practice.
5010 Questions or Concerns?
If you have any concerns about the effect of 5010 on your practice, please contact your SPOC.
Eldad De-Medonsa
President
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