Webinar: Small practices need to get going on 5010
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Griffin, along with moderator Nancy Spector, director of electronic medical systems at the American Medical Association (AMA); and Alisa Taylor, medical billing specialist at Alamogordo Urology at Alamogordo, N.M., spoke at a Get Ready 5010 webinar on April 4.
The event kicked off a week of webinars to prepare stakeholders for the conversation to HIPAA 5010--a standard that regulates the electronic transmission of specific healthcare transactions. The series was sponsored by organizations including the Health Informatics Management & Systems Society (HIMSS) and the AMA.
The experts' advice for small practices? “Make 5010 data changes now,” advised Spector. “All data changes are backward-compatible with version 4010.” However, practices must test their conversions before going live with 5010. Smaller practices need to talk to their vendors now to find out what they need to do to upgrade to prepare for this change, according to Griffin. “It is important to test early,” she added. “You don’t want to get caught in the 5010 traffic jam.”
After the short 30-minute presentation, the speakers took questions from listeners, including these:
I only receive mail at a P.O. Box. How is changing our physical address going to affect small practices?
The billing provider address in Version 5010 must be a physical street address so the address needs to be the location of the billing provider. If a practice is using a P.O. Box address for reimbursement checks, you can still do that but you have to report that P.O. Box in the “pay to” address loop. If you haven’t already gotten communication from your payor about this change, you’ll want to reach out to your payor if you’re making this change. Payors may be using what they’re getting in the billing provider address loop to validate that the provider coming in matches with the provider and their enrollment on their files.
What if the referring provider address is a P.O. box? Does it need a 9-digit ZIP code?
The referring provider address does not get reported in the claim. It’s just the referring provider’s name and their identification like their master patient index or secondary identification number, so there’s no need to worry about their ZIP code.
Will it be helpful to employ an outside consulting firm to take care of data needs for 5010?
For 5010--depending on size of your practice and other information you may be getting elsewhere--you might find you’ll be able to do it yourself, but if you’re a large practice, you might want some extra help. What works for one practice might not work for another.
Does 5010 apply to psychotherapists?
As a psychotherapist, you are a provider so you are a covered entity under HIPAA, and if you’re doing electronic transactions, you need to use the HIPAA-complaint format which will be Version 5010 transactions as of Jan. 1 2012. So in a roundabout way, yes. HIPAA doesn't require covered entities to do transactions electronically, though.
Are all vendors up to speed with 5010 conversion and is there a deadline for them to be compliant to get us test ready?
It’s vendor-by-vendor as to who’s ready and who’s not. Reach out to your vendor immediately and find out where they are in their upgrades and when you may be able to install them in your system.