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Be Prepared for ANSI 5010
If you have not configured your software to send 5010 claims, you are not ready!
Useful Documents:
- Instructions for Configuring Medisoft for ANSI 5010 - Download
- Relay Health's ANSI 5010 Preparation Guide - Download
- Relay Health's List of Common 5010 Rejecions - Download
ANSI 5010 requirements are coming up fast. Starting January 1st, 2012 all electronic claims will be required to be transmitted in ANSI 5010 format. Will you be ready? Are you ready now? Do you even know what ANSI 5010 is? We can help.
What Is ANSI 5010?
ANSI 5010 is the new Standard, or guidelines, for sending electronic claims. Currently electronic claims are sent in ANSI 4010 format. This format is being replaced in part to address many of the shortcomings in the current version, including the fact that ANSI 4010 does not support forthcoming ICD-10 coding.
When Does It Take Effect?
As of January 1st, 2012 ALL electronic claims will be reuired to be sent in ANSI 5010 format. Anything that is not will be rejected.
How Important Is This Really?
Can you afford to stop receiving insurance payments? For Weeks? Months? Do you remember the transition to NPI? This is just as critical. If you are not sending ANSI 5010 claims on January 1st, your incoming cash flow will cease to exist. It's that serious. Get prepared now and be ready, it's easier than you think.
What Version of Medisoft Do I Need To Be Ready?
Medisoft Version 17 is the minimum required version of Medisoft that is ANSI 5010 compliant. In addition you must also be using Revenue Management and a connection that is 5010 Compliant. (Relay Health is the recommended connection)
What if I use a 3rd Party Clearing House and Send Text Files?
First of all, text files are NOT in ANSI format at all. Text file is nothing more than a copy of a paper claim form. This is not an electronic claim, even though you may send the file electronically. Since these are not ANSI claims, they are not ANSI 5010 compliant.
But My Clearing House Says They Will Convert Our Claims To ANSI 5010 For Us.
A lot of clearing houses have made this statement. In reality, there is no way for them to do this. In order to create an ANSI 5010 claim, you need all the information that is required on the claim. This information is not sent on paper or ANSI 4010 claims. There is no way to convert a claim to ANSI 5010 format.
When Should I Start Worrying About This?
Now. Most clearing houses and insurance companies are accepting ANSI 5010 claims right now. Don't wait until last minute to get prepared. If you are not prepared now you are risking a complete halt to your cash flow. After Jan 1st, electronic claims not in ANSI 5010 format will not be paid.
What If I Am Not Sure If My Practice Is Ready?
We are here to help. First, make sure you have the latest version of Medisoft, version 17. If not, contact us to purchase an upgrade. If you are still not sure, please call us and we will be happy to get you in the right direction and prepared for the upcoming changes.