The Centers for Medicare & Medicaid Services Office of E-health Standards and Services recently announced it will loosen ASC X12 Version 5010 standards compliance enforcement, with a 90-day discretion period for all HIPAA-covered entities, according to an AAPC report.
CMS said it will initiate enforcement on office-based physicians, health insurance plans and claims clearinghouses starting on March 31, 2012. CMS made this decision following industry feedback from organizations that aren't ready to finalize 5010 standards system upgrades.
AAPC pointed out that providers do not have a delay of implementation. While payors may not be implementing 5010 in January and there will be no penalty, failure to use 5010 means no reimbursement.
MGMA asked CMS to "immediately issue a comprehensive contingency plan" that would allow health plans to keep processing non-compliant healthcare claims. The organization made this request after a member survey indicated only 35 percent had begun testing for 5010 use.
Related Articles on Billing, Coding and Collections:
HHS Study: Medicare Contracts Often Pay Claims Using Expired ID Numbers
Oklahoma Governor Approves Health Insurance Rule Change
Maine Residents to Protest Cuts to Medicaid Program
CMS said it will initiate enforcement on office-based physicians, health insurance plans and claims clearinghouses starting on March 31, 2012. CMS made this decision following industry feedback from organizations that aren't ready to finalize 5010 standards system upgrades.
AAPC pointed out that providers do not have a delay of implementation. While payors may not be implementing 5010 in January and there will be no penalty, failure to use 5010 means no reimbursement.
MGMA asked CMS to "immediately issue a comprehensive contingency plan" that would allow health plans to keep processing non-compliant healthcare claims. The organization made this request after a member survey indicated only 35 percent had begun testing for 5010 use.
Related Articles on Billing, Coding and Collections:
HHS Study: Medicare Contracts Often Pay Claims Using Expired ID Numbers
Oklahoma Governor Approves Health Insurance Rule Change
Maine Residents to Protest Cuts to Medicaid Program