5010 Update Kevin Rogers SCDHHS Project Management Office November - - PowerPoint PPT Presentation

Kevin Rogers SCDHHS Project Management Office November 17,2011

5010 Update

Project Status

• On schedule for 1/1/2012 implementation
• External testing began 10/19/2011
• New translator being installed at Clemson
• Minimal compliance approach
• Same Medicaid EDI editing rules for 4010 apply to

5010

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Status of External Testing

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837I Trading Partners Passed

• HEALTHPORT/EMEDIX
• GATEWAY EDI
• MCKESSON
• PER-SE TECHNOLOGIES
• NDC HEALTH
• THE SSI GROUP INC
• ANDERSON AREA MEDICAL CENTER 01
• FASTRACK HEALTHCARE SYSTEMS
• QUADAX
• HCA PATIENT ACCT SVCS
• HEALTHCARE BUSINESS SERVICES
• LOWCOUNTRY BILLING
• REIMBURSEMENT TECHNOLOGIES
• NOVANT HEALTH

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Important Dates

• 11/11/11 – No new trading partners for 4010
• 12/29/11 – Last day to send 4010 transactions. Cutoff is

6:00pm

• 1/1/12 – First day to send 5010 transactions
• 1/6/12 – Last 4010 835
• 1/13/12 – First 5010 835

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Follow Up

• TPs should contact SCDHHS EDI Helpdesk for assistance and

information about the process

• TPs not tested and approved in MMIS submitter tables for 5010 will

have their transactions rejected effective 1/1/12

• All trading partners should be contacting the EDI Helpdesk to

establish testing and pass compliance before 1/1/12

• EDI Helpdesk will begin conducting focused outreach (by phone and

email) to TPs that have not tested with us. Detailed reports will be created beginning 11/21/11.

• If there is a possibility of increase in paper claim billing, please let us

know as soon as possible

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Reference Information

• EDI Support:

– Phone: 1-888-289-0709 – Email: edig.ops-mcaid@palmettogba.com

• SCDHHS Website:

– http://www2.scdhhs.gov/resource/hipaa-5010- project-status

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Thank You!

QUESTIONS???

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