All entities covered by the Health Insurance Portability and Accountability Act (HIPAA) that submit transactions electronically are required to upgrade from Version 4010/4010A to Version 5010 transaction standards by Sunday, January 1, 2012. It is important to remember that the upcoming Version 5010 transition is not only mandatory, but is also an integral step toward a successful ICD-10 transition.
It is essential to test both internally and externally with business partners prior to the Version 5010 deadline in order to assure that all trading partners are able to send and receive compliant transactions effectively, and in advance of the transition deadline. Take action now to ensure compliance and avoid problems with submitting claims for reimbursement after Sunday, January 1, 2012. If you have not yet begun external testing, you should make use of the following risk mitigation strategies: • Communicate with vendors and trading partners regularly. Encourage them to take action now and establish a communication plan. • Reach out to a clearinghouse for assistance. A clearinghouse ensures that claims smoothly transition between practices and payers and can serve as a translator for non-compliant transactions from the Version 4010/4010A to the Version 5010 system. If you are concerned that your internal systems may not be ready by Sunday, January 1, using a clearinghouse that is already ready to process Version 5010 claims can help ensure your reimbursements are not interrupted while you bring your own systems into compliance. • Establish a line of credit. Establishing or increasing a line of credit will help cover potential cash flow disruptions from delayed reimbursement claims. • Take advantage of available resources. There are many different resources offering valuable information to organizations looking to streamline their Version 5010 transition. CMS offers several tools <http://links.govdelivery.com:80/track?type=click&enid=bWFpbGluZ2lkPTE0ODc0NjQmbWVzc2FnZWlkPVBSRC1CVUwtMTQ4NzQ2NCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2ODMzNDEmZW1haWxpZD1jaGFybGllLmVsZWZ0aGVyaW91QGNtcy5oaHMuZ292JnVzZXJpZD1jaGFybGllLmVsZWZ0aGVyaW91QGNtcy5oaHMuZ292JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&100&&&https://www.cms.gov/ICD10/02b_Latest_News.asp#TopOfPage> to help you plan and execute your transitions to Version 5010 and ICD-10. Beyond CMS, many professional societies and organizations offer guidance and resources to help you transition. Keep Up to Date on Version 5010 and ICD-10 Please visit the ICD-10 website<http://links.govdelivery.com:80/track?type=click&enid=bWFpbGluZ2lkPTE0ODc0NjQmbWVzc2FnZWlkPVBSRC1CVUwtMTQ4NzQ2NCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2ODMzNDEmZW1haWxpZD1jaGFybGllLmVsZWZ0aGVyaW91QGNtcy5oaHMuZ292JnVzZXJpZD1jaGFybGllLmVsZWZ0aGVyaW91QGNtcy5oaHMuZ292JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&101&&&http://www.cms.gov/ICD10> for the latest news and resources to help you prepare, and to download and share the implementation widget<http://links.govdelivery.com:80/track?type=click&enid=bWFpbGluZ2lkPTE0ODc0NjQmbWVzc2FnZWlkPVBSRC1CVUwtMTQ4NzQ2NCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2ODMzNDEmZW1haWxpZD1jaGFybGllLmVsZWZ0aGVyaW91QGNtcy5oaHMuZ292JnVzZXJpZD1jaGFybGllLmVsZWZ0aGVyaW91QGNtcy5oaHMuZ292JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&102&&&http://www.browserspring.com/widgets/cms2/iframe.html> today! ------------------------------------------------- Each Office Visit is an Opportunity. Medicare patients give many reasons for not getting their annual flu vaccination, but the fact is that flu seasons are unpredictable and can be severe. Each year, it is estimated that 90 percent of seasonal flu-related deaths and more than 60 percent of seasonal flu-related hospitalizations occur in people 65 years and older. Please talk with your Medicare patients about the importance of getting their annual flu vaccination. And remember, vaccination is important for healthcare workers too, who may spread the flu to high risk patients. Don’t forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get the Flu Vaccine—Not the Flu. Remember – The flu vaccine plus its administration are covered Part B benefits. CMS has posted the 2011-2012 seasonal flu vaccine payment limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that the flu vaccine is NOT a Part D-covered drug. For more information on coverage and billing of the flu vaccine and its administration, as well as related educational provider resources, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and http://www.cms.gov/immunizations. ------------------------------------------------------ Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/ContactCMS). Thank you.
