November 2011 Newsletter
Down the Stretch: ANSI 5010 Is Almost Here!
With the official deadline to switch to the 837 5010 format less than two short months away, “T-Day” (Transition Day) is just around the corner! The imminent arrival of January 1, 2012 has providers and payers alike scrambling to make last minute adjustments and conduct tests to ensure that they are in compliance with this important ANSI standard. But Quadax is in the thick of the 5010 transition, and has already established significant inroads towards the final push to transition payers to the new format.
Currently, Quadax is transmitting claims in the ANSI 5010 format to 48 Institutional (UB) payers and 61 Professional (1500) payers with minimal issues. Many of these are larger payers, which have been at the forefront of the conversion process. For example, Quadax transitioned Emdeon Institutional claims to the ANSI 5010 format on October 31 (Halloween!). While the thought of this changeover may have been scarier than a zombie movie for some of our clients, there were no tricks that day… just treats in the form of successfully submitted claims. And that’s just the beginning!
There are currently 19 Institutional payers and 67 Professional payers in an “Approved” status, meaning that our ANSI 837 5010 format has been approved by the payer's testing system. This means Quadax will most likely be in ANSI 5010 Production status with an additional 86 payers in the next few weeks! Because testing varies from payer to payer, there may be minor tweaks (at Quadax or the payer) that need to be addressed before these payers can be moved to a production status. But in the majority of these cases, Quadax is simply waiting for confirmation from the payer about the proposed 5010 Go Live Date.
For those clients that have successfully submitted ANSI 5010 test files with Quadax, rest assured that we will be ready to submit claims to all payers that are able to accept claims in the 5010 format by the deadline. But if the day-to-day realities of your business office have prevented you from getting the ball rolling on this mandatory transition, don’t fret! There is still some time left. But you must act quickly!
Of course, not all payers will be ready for the January 1 deadline, despite the mandate by ANSI. A number of payers, primarily Medicaids, have publicly stated that they will still be accepting claims in the ANSI 4010 format well into 2012. In fact, a statement from the Centers for Medicare and Medicaid Services (CMS) issued on November 17 indicates that its Office of E-Health Standards and Services (OESS) “would not initiate enforcement action until March 31, 2012, with respect to any HIPAA covered entity that is not in compliance with the ASC X12 Version 5010 (Version 5010).” But this is no reason to relax or postpone current ANSI 5010 transition efforts!
If you have not done so already, Quadax strongly encourages our clients to submit ANSI 5010 837 test files (both UB and 1500s, as appropriate) to us to ensure that your claims transmissions are properly setup and able to be accepted by the intended payer. Contact your Account Representative or the Quadax Help Desk to learn more about the testing process and how to initiate it.
No matter where you currently stand with the ANSI 5010 transition, Quadax is committed to making the 5010 transition as seamless and worry-free as possible, and is ready to assist you in any way we can!