Start the process now and reduce the risk of rejected claims and decreased cash flow as ANSI 5010 is adopted.
Why you need a plan: Impact on Providers
The implementation of HIPAA 5010 means substantial changes in the data that you submit with your claims, as well as the data you receive in response to your electronic inquiries. The implementation requires significant changes to the software, systems, and perhaps procedures that you use for billing Medicare and other payers.
Beware! We are hearing messaging from various clearinghouses that they will be able to convert ANSI 4010 claims up to ANSI 5010 claims. In a number of circumstances this is absolutely valid, but is at best a short-term solution. There are volumes of new data fields in 5010 that do not exist in 4010. In order to do a conversion from 4010 up to 5010, clearinghouses will be making some assumptions and will have to “hard code” values into data fields that do not exist in 4010. In doing so, this will increase the likelihood of experiencing some additional claims rejections.
To minimize the possibility of problems, Medworks suggests moving to the ANSI 5010 compliant version of Medisoft (version 17) now rather than later so you can submit claims and have all the valid data fields necessary to successfully transmit 5010 claims.
We see risk and believe insurance carriers will utilize the transition from 4010 to 5010 as a means and a reason to increase the rates of rejections by changing things up and identifying places where they make changes to their requirements. This might cause providers to experience a higher level of rejections, as well as experience an imbalance between the levels of claims filing and claims payments. What is the likelihood that some busy practices might just let the rejected claims slide allowing the insurance carriers to keep the money? We don’t like to think Payers play these kinds of games, but in reality we all know they do. This is why Medworks recommends you adopt Medisoft v17 now.
As the Meaningful Use guidelines have been finalized for stimulus payments, we now know that it is more critical than ever to start implementing EMR. As previously reported, Medisoft Clinical has earned certification as a “Complete” electronic health record (EHR) system per the Office of the National Coordinator (ONC) Authorized Testing and Certification Body (ATCB) process.
There are many reasons why you should consider starting now.
First the positive reasons:
Next, the harsh reasons:
McKesson introduces Quick Reference Meaningful Use Guide for Eligible Providers. This document helps practices utilizing Medisoft Clinical v17 prepare for meeting MU requirements.
Medicare will pay for annual wellness exams starting January 1, 2011. Be sure to check the CMS website for guidelines.
Medicare Reduces Timely Filing. Claims with dates of service January 1, 2010 and later received more than 1 calendar year beyond the date of service will be denied as being past the timely filing deadline. Reference this article for more information.
Horizon BC/BS paper claims must be on red CMS-1500 Forms. Many practices have been submitting on laser-printed black-on-white formats, which is no longer acceptable.
Improve patient payment response using BillFlash.
Medisoft version 17 comes fully integrated with BillFlash which allows users to deliver large batches of printed patient statements in just 5 minutes. Everyone wins: physician practices save time and money while patients receive professionally printed statements incorporating personal messaging.
Are you leveraging the best technologies to increase productivity?
Imagine eliminating the labor intensive process of printing, folding, stuffing, sealing, stamping, mailing and troubleshooting. BillFlash is easy to setup and will:
• Generate immediate cost savings
• Increase patient collections
Why not consider a no obligation trial?