CEDI News: Important Information for Medicare Fee-for-Service Providers

Important Information for Medicare Fee-for-Service Providers

Only 79 Days Left Until Full 5010 Implementation
The Health Insurance Portability and Accountability Act (HIPAA) 5010 compliance date is fast-approaching. There are only 79 days left until full implementation on January 1, 2012.

As of January 1, 2012, Version 5010 will be required for all HIPAA standard transactions. This means:

Beginning January 1, 2012 HIPAA Version 4010A1 will no longer be accepted by Medicare.
All trading partners must operate in HIPAA Version 5010.

It is essential to begin the transition now to prevent a disruption to your claims processing and cash flow.

If you have not done so already, the Centers for Medicare & Medicaid Services (CMS) strongly encourages you to begin exchanging Version 5010 transactions with your Medicare Administrative Contractor (MAC) now to ensure compliance with the January 1, 2012 impact date.

As a reminder, CMS offers free billing software that is Version 5010 compliant. Please contact your MAC, fiscal intermediary (FI) or carrier to obtain the latest version of PC-Ace Pro32. CMS also provides the Medicare Remit Easy Print (MREP) software to view and print compliant HIPAA 5010 - 835 remittance advices. Please visit http://www.cms.gov/AccesstoDataApplication/02_MedicareRemitEasyPrint.asp

to view this software.

More information:
Medicare Fee-for-Service (FFS) providers should take advantage of the many resources we have provided on the 5010 dedicated Web site located at https://www.cms.gov/Versions5010andD0/

.

Don't wait! TEST NOW to avoid possible delays in payment due to the end-of-year rush in 5010 testing. Testing now will allow time for any needed corrections prior to Jan 1, 2012 - the date when only 5010 transactions will be accepted.

Make Sure You Know How to Meet Version 5010 Level II Compliance

The Version 5010 compliance deadline is less than 90 days away.
All entities covered under the HIPAA must be ready to implement the Version 5010 transaction standards by December 31, 2011. In order to meet this compliance deadline, you need to conduct both Level I Internal Testing, and Level II External Testing of transactions.

Level I Internal Testing
Level I Internal Testing allows you to identify and address any potential issues that may arise in advance of testing with external business partners. If you have not yet done so, take action now to complete your internal testing as soon as possible. By now, you should have completed Level I Internal Testing, and begun Level II External Testing.

Level II External Testing
For Level II External Testing, you should identify the business partners you currently conduct transactions with, and create a schedule and timeline for external testing with each partner. If you trade with a large number of business partners, identify priority partners to conduct testing with first.

To meet Level II compliance, business partners that should be included in external testing include:

Billing services
Clearinghouses
Pharmacies
Entities responsible for coverage and benefit determinations
Payers

To ensure a smooth transition during Level II External Testing, you should first test the transactions you currently use on a daily basis, such as:

Claims
Eligibility determinations
Remittances
Referral authorizations

After testing your daily transactions, you are ready to test all remaining transactions to ensure that you are fully compliant for Level II External Testing.

Keep Up to Date on Version 5010 and ICD-10.
Please visit the ICD-10 Web site

for the latest news and resources to help you prepare, and to download and share the implementation widget

today!

Important 5010/D.0 Implementation Items

The HIPAA 5010 compliance date is fast-approaching. There are only 79 days left until full implementation on Sun Jan 1, 2012. Please contact your local Medicare Administrative Contractor (MAC) and TEST NOW!

REMINDER - January 1, 2011 marked the beginning of the 5010/D.0 transition year
REMINDER - Versions 5010 & D.0 FAQs are Available
REMINDER - National Testing Day Message
REMINDER – 5010/D.0 Errata requirements and testing schedule can be found here
REMINDER – Contact your MAC for their testing schedule
READINESS ASSESSMENT – Have you done the following to be ready for 5010/D.0?
READINESS ASSESSMENT – What do you need to have in place to test with your MAC?
READINESS ASSESSMENT – Do you know the implications of not being ready?

5010/D.0 Implementation Calendar

Current Events

October 2011

24th–27th:

WEDI 2011 Fall Conference*

Upcoming Events

November 2011

9th	CMS-Hosted 5010 National Call - HIPAA 5010 Status Update

December 2011

7th	CMS-hosted 5010 National Call - Question & Answer Session
31st	End of the transition year, and the beginning of 5010 production environment

Past Events:

For a complete list of past 5010 National Calls, please visit the 5010 National Calls Section of Our Versions 5010 & D.0 Web site.

*Information about events in which CMS Medicare FFS staff participates may be applicable to the healthcare industry at large, though the events are geared toward the Medicare FFS audience.

Post Date 10/13/11

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