5010 Standards- Ten Questions to Ask Your Medical Biller
5010 Standards- Ten Questions to Ask Your Medical Biller
By 1-1-12, billing software vendors, clearinghouses, and payers will have to comply with the new Health Insurance Portability and Accountability Act (HIPAA) ASC X12N 5010 electronic transaction standards (known as version 5010). (Note: This replaces the current ASC X12N 4010A1.)
The 5010 version addresses new upgraded standards regarding electronic exchange of administrative and financial information between health plans, health care providers, and their related clearinghouses for patient care services and treatments. The aim is to enhance the electronic information exchange, electronic claims submissions, claims status inquiries, remittances, referrals, treatment authorization and other "back room" medical practice operations.
Because of this process, which can take a while to implement, you want to ask your medical biller the following questions to make sure you will be compliant by the required date.
When will the system be upgraded with the 5010 standards?
Does the vendor contract include an update to the 5010 standards? (Note: If not, you may be required to pay for the upgrade and will want to know the cost.)
Will the yearly fees be increased to account for the cost of 5010 implementation?
What kind of new hardware, if any, will need to be purchased?
Will the 5010 implementation require any additional training for the staff? If so, where can good training be obtained?
What kind of testing and validating process will be available to see if any problems occur when submitting claims?
If there are problems when submitting claims, what kind of support can be expected?
Is the 277 Claims Acknowledgement electronic transaction, that reveals any errors in a claim, included in the 5010 version?
Does the 5010 upgrade include a Functional Transaction 999 to indicate that the claim was accepted by the carrier?
If there is an error with a claim, will a readable error report be generated? If so, will it be compatible with the current system?
After the questions are answered, then it is time to develop a 5010 transition plan for your practice. It should include the following seven points:
The training of the clinical and administrative staff
Reviewing the current system compatibility
If necessary, updating or replacing the practice-management-system software
Modifying the new workflow
Checking to see if any hardware upgrades will be necessary
Evaluating and developing the data requirements for vendors, clearinghouses, and health plan provider contracts
Establishing the appropriate budget that will be used to implement these new requirements
There is a lot at stake in making sure your practice is fully compliant with version 5010 by the 1-1-2012 date.
Medical Billing- Three Ways to Prevent Leakage All About The True Medical HEPA Filter Systems Numerous Benefits Offered By Medical Loupes Medicine For Premature Ejaculation - 3 Easy To Use Products That Can Help You Last 5 Times Longer ! Medicine For Premature Ejaculation Command Premature Ejacultion Through Drugs - Could it be Safe? Senior Medical Alert Systems – Safer Independent Living for Your Grandmother Drug Testing Has Become Very Easy And Fast Why The Indian Medicine Bag Is Such A Powerful Good Luck Amulet! Why The Indian Medicine Bag Is Effective Good Luck Amulet! Preparing Medical Freight During Hot Weather Medical Assistant Colleges Medical And Cosmetic Rhinoplasty Basics In Los Angeles How To - Medical Treatments May Not Cure Premature Early Ejaculation - The Truth Exposed