5010 Billing
Once you have installed IMA V19, here is some guidance on implementing and testing 5010 billing.
Enabling 5010
Enabling version 5010 billing is quite simple. It is enabled for each payer in System Administration -> Billing Definitions -> Electronic Billing Files, by selecting the desired Payer, and switching the version from 4010 to 5010 on the "Setup" tab.
Testing
The initial testing should be done in the "testsytem". Please make sure that the "Exchange Test Indicator" in the "Receiver" record is set (The "Receiver" record is accessed in Administration -> Billing Definitions -> Electronic Billing Files) to ensure that test claims are not processed as real claims.
Medicaid Note
Medicaid in EMEDNY has standardized the naming they use for the different files that can be downloaded. All will be recognized by the IMA HIPAA file manager. Here is a list of the applicable ones:
.010001.x12 - TA1 (Rejected File) (5010) .020001.x12 - "F" File Rejection Notice (4010) .030001.x12 - 999 Functional Acknowledgement (5010) .040001.x12 - 997 Functional Acknowledgement (4010) .050001.x12 - CA277 Claim Status Response (5010) .060001.x12 - U277 Claim Status Response (4010) .070001.x12 - 278 MEVS Authorization Resp. (4010) .100001.x12 - 271 MEVS Eligibility Response (4010/5010) |