A letter to the FastEMC client base and other interested parties on our progress.
Well it will not be long and we will be looking the ANSI5010 transition straight in the eye. We are hoping we have designed a transition that will be most gentle. Instead of making a hard transition from ANSI 4010 to ANSI 5010, we decided to set this up with extreme flexibility.
The code files that keep your procedures, diagnoses, facilities, providers, patients and codes are shared between your ANSI4010 and ANSI5010 claims. We did not see any good reason to try to force your ANSI4010 system to act like 5010. It just would not work.
So our plan is as follows. We upgrade your programming with some minor patches to the existing system but mostly with regard to the shared files. You can continue to send 4010 claims as needed. You can enter claims into the 5010 side for testing and practice. We have given you a separate ISA/GS setup for each version so you can do test claims for 5010 and production for 4010 without issue. We also added a HOT button in 4010 that will let you push an existing claim to the 5010 side for testing – to save data entry. You will still have to review the claim and add or check some new requirements to make sure it passes edits but we are finding this handy.
Once you have familiarized yourself with the new 5010 claims requirements and data entry screens, you will be able to start entering your claims directly into 5010 and leave the 4010 system behind. We leave you access to 4010 on the menus and depending on the transition rules as you follow-up on those claims you may need to resubmit them using 4010 or you can push them to 5010 and process in that environment. (We have not seen a final ruling about if this is going to be based on Date-of-Service or Date Submitted at the 01/01/2012 cut off. )
For practices using Total Cycle, Patient Statements will pull from both sides to provide a consolidated statement to patients. Gradually all the claims on the 4010 side will be paid up and you will keep that data for history.
For practices that download claims, you would select the right version when you download your files and that will be all that is necessary.
This will give us a fall back to 4010 format if we discover issues with your submission of 5010 claims. There are requirements that might send you back to enrollment and if those things were not handled early you may find some delays.
So once we start our installs, you will be able to continue in the 4010 mode. We will have time to run training sessions to familiarize you with the new features and requirements. To make this more efficient we will schedule group training with our on-line training center and you will be able to select a class or classes as needed. These are going to be web-based and will just require a web access and browser at your end.
You will be pleased to note that the new 5010 system is very much like your current 4010, but we did need to make changes that will make the 5010 system work correctly. We have pulled many pieces of data out of hiding and given you a way to clearly tell what you are submitting. We have removed all the weird rules that had grown into the system that were for certain states, Payers or taxid’s. One huge difference with 5010 is that they added proper places for all that stuff so it does not have to be tucked into unusual fields. We added a place for everything that might be sent. I expect this will make it easier for us all.
PROFESSIONAL TESTING: We are running various types of claims up to different clearinghouses and payers. The Professional side is the first we have ready and it is moving right along.
INSTITUTIONAL TESTING: This testing has not started yet, but is close. We could really use some people that do institutional claims to enter an assortment into our test system.
CLIENT Participation: If there are any clients, that would like to play with our test system(s) and give us some feedback on the new data entry structure, give me a call (800-326-4831 ext 710). We will set it up.
So let’s move forward with ANSI 5010 and get this craziness over. I am sure we are all ready to move on to the ICD-10 upgrade that follows this install. BTW – ICD-10 changes are included in this install. We will not worry about those until later.
Sincerely,
Nancy Palmquist
CEO FastEMC/Triangle Medical Solutions, Inc.
