4010-to-5010 ~ My Filing Nightmares ~ Rejected Claims, Unreadable Reports, and Error Messages, Oh My!

4010-to-5010 My Filing Nightmares
Rejected Claims, Unreadable Reports, and Error Messages, Oh My!

Has the 4010 to 5010 transition confused you or your office staff with rejected claims, unreadable reports, and/or error messages? The following are some helpful websites and information my staff gathered while making the fun transition.

http://www.ama-assn.org/resources/doc/washington/4010-to-5010-claim-data-reporting-comparison.pdf

If you upload your claims using a clearinghouse your should get a human readable electronic report. (If you are getting a human readable report, count yourself lucky!) However, if you upload your claims directly to the Medicare Carrier you might only get a 999 file and a 277CA file. Acknowledgement for Health Care Insurance (999) and Claims Acknowledgements (277CA) will open in Notepad and contain a couple lines of code in your report because they no longer require themselves to send human readable reports. Talk to your software company and ask if they can provide the translation software. There HIPAA EDI Viewer software companies out there. More info about this topic:
http://www.wpsic.com/edi/5010-Readiness.shtml
https://www.cms.gov/Versions5010andD0/Downloads/2nd_National_Provider_Education_Call_HIPAA_Versions_5010_and_D0.pdf

If you have any questions, or suggestions please feel free to post them below. We are always looking for more information to share.

~Dr. Street