This week's HIPAA 5010 readiness webinar was mostly an opportunity for CMS staffers to regurgitate the same news they've been blasting in our inboxes for weeks. But there were a couple of warning shots you definitely should heed.
The main topic was preparation for the July 1 cutover from the 4010 version.
However, the 40-minute Q&A period yielded a few interesting tidbits as to how to fend off any payment hiccups starting next month.
For instance, while CMS has presented monthly reports showing more than 95% of all Part B claims are successfully coming through in the 5010 format, the Medicare agency makes no such promises for private health plans.
Sample dialogue:
Provider question: “Anything I need to do regarding the other private insurance companies to make sure they are ready for the transition?”
Jason Jackson, CMS central office: “If you’re asking about crossovers, we’ve been informed they’re all ready. If it’s claims submission, you need to do outreach to the individual payers to ensure they’re ready.”
In other words, if Medicare isn’t involved in the claim, then CMS cannot assure the commercial payers are ready.
During its presentation, CMS repeated its earlier announcement that for the first month of HIPAA 5010 enforcement, remittance advice would remain in the 4010 format. CMS provided no further details other than to say that this is absolutely the only area where 4010 can be processed beyond July 1.
One final note: It might be time for those of you in California and Montana to get a bit nervous about Medicaid claims next month -- CMS announced in the webinar that those are the only two states whose Medicaid programs had yet to inform CMS they could process 5010.