5010 Tip #4

You went to an EMR/EHR in preparation for the regulation changes in the Healthcare Industry for 2014 and to avoid a deduction in Medicare Claims Payment.  That was a huge financial cost to your practice and the last thing you anticipated was having a cash flow crisis to the industry electronic claim file changes that CMS ruled would take place January 1st, 2012.  I know.  Remember, like you, I am experiencing the 5010 fiasco I blogged about here with my clients, so I totally relate to your pain.  However, I hope by now you are making great strides in the conversion.  If not, I am sorry.  I wish I could fix it with a magic wand, however, I can’t.  I can provide you a few pieces of information that might help you get some cash flow turnaround quickly and will be posting a few tips on Version 5010 that will provide you some resources to help you make headway through to get some answers to your problems.

You are having major cash flow crisis issues.  You don’t know what the freake is up with your claims.  You don’t know if your carrier is getting them because your Carrier Reports and Carrier Responses may be inconsistent, your software vendor may or may not know what is wrong or how to resolve, and you are frustrated.  Have you considered dropping your claims to paper to get them to the carriers?  Yes, that does mean that it takes longer to get paid, but right now the concern is getting paid, right?

In December 2011, before 5010 Implementation Date, I advised all my clients to stock up on 1500 Claim Forms.  One of them looked at me like I was insane and commented, “Why would we want to send paper claims?”.  I reassured the client that I would rather be prepared and have the forms that would be needed in the event that we should have to drop our claims to paper  and that the electronic submission format was the prime method we would use, but in the event we get backlogged with issues, we will need to get claims out the door so that we can get them processed, even if that adds a week to three weeks to the process, that is better than no process at all.  Were they grateful that they followed my recommendation so that we could print a mountain of paper claims the 2nd week of January?  You bet they were!

Come back next week for another 5010 Tip!

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