So, what is 5010 all about? How does it affect you? And, what’s Kareo doing to help you stay in compliance?
In a nutshell, 5010 is a new transaction set for electronic medical claims. If you’re a medical biller or someone who has anything to do with sending medical claims electronically, then you’re affected. Mandated use of the new 5010 transaction set goes into effect industrywide on January 1, 2012. (Peek at the calendar…) …That’s in less than 2 months.
Here’s a summary about 5010 that our very own Terry Douglas was kind enough to put together for us.
As you would expect, all the parties in our industry are gearing up for it. Many of us are tweaking systems and processes now in anticipation of the cutover on January 1.
The thing is, some payers are beginning to accept the new format even before January. Depending on your relation to those payers, you could be impacted now in the form of rejected claims due to the mismatch between your existing settings and the transaction set those payers have enabled early.
There’s Something You Can (And Should) Do Now
All this is to say that there are a few settings updates you can do now in your Kareo software to help make a smooth transition, regardless of when your payer decides to enable 5010 on their system. The video series below (a 3-parter) will show you — step-by-step — what you need to know.
In addition to the video above, Corena Bahr — the writing wizard behind our Kareo manuals and technical guides — has also made available the 5010 Compliance Checklist for Kareo Users that you can download now for just the price of a click.
Check out both the video series and the checklist above. And, as always, if you have further questions, feel free to post them in the comments below or hit up our Support line (even better so they can assign a case number to your question).
Cesar said:
Do I need to update patient’s address to 9-digit zip codes too?
Wednesday, November 30, 2011 - 6:28 am
Heather H said:
Am I correct in my understanding that I do not need to update my zip codes for all my insurance companies?
Wednesday, November 30, 2011 - 6:31 am
Kathy McCoy said:
Thanks for a good question. The patient’s addresses do not have to be 9 digits. Let us know if you have additional questions.
Wednesday, November 30, 2011 - 4:21 pm
Kathy McCoy said:
Heather, thanks for asking. Jim Millen, our 5010 expert on staff, advises that the zip codes for the insurance plans or companies do not have to be 9 digits.
Wednesday, November 30, 2011 - 4:22 pm
Noe said:
Do I need to change all patient PO box address to a physical address?
Tuesday, December 13, 2011 - 10:47 pm
Noe said:
Will the system eventually populate all zip codes with the 4 digit codes?
Tuesday, December 13, 2011 - 11:10 pm
Alecia said:
It says no PO Boxes. Is that for place of service or does it mean mailing/billing address for providers. We live in a very rural area and only have delivery AT the PO.
Wednesday, December 14, 2011 - 10:39 am
Kathy McCoy said:
Yes, we are currently doing that right now only for Service Location addresses, Practice Information Addresses, and Provider Addresses. If you don’t see a 9 digit zip in those areas, then our system could not match the zip code with a valid address on file so you would have to manually update in those situations. Thanks for a great question!
Wednesday, December 14, 2011 - 2:28 pm
Kathy McCoy said:
No, patient addresses are not affected by any 5010 changes. Thanks for reading our blog. Let us know if you have any other questions.
Wednesday, December 14, 2011 - 2:28 pm
Kathy McCoy said:
You cannot have PO Box addresses for Providers in the following areas: Provider Addresses and Practice Information addresses. If you have a PO Box for a location you wish to receive payments to, you must use the new Pay To Provider areas in the Provider records.
Wednesday, December 14, 2011 - 2:30 pm
Kathy said:
Just to clarify: We only get mail at our PO Box. From my understanding I go to each provider and enable pay to address. Do I enter the name of the provider to go with the address or do I use our business name for the name?
Monday, December 19, 2011 - 1:15 pm
Kathy McCoy said:
Hi, Kathy–
Customer Support advises that you would have to call the payer if you are not sure. Typically, this would be the same as whatever name you were sending as the Billing Provider.
We hope this is helpful. Thanks for reading our blog!
Tuesday, December 20, 2011 - 2:20 pm
Laura H said:
Kathy-
We just noticed that in the Claims Setting section, under the Override EIN? option, there now appears an option that says Enable Pay to Address. Do we need to check off and complete this option? We’ve watched all the 3 parts of the video series and have made the required updates but this was not mentioned and it does not appear in any of the videos.
Thursday, December 29, 2011 - 10:35 am
Kathy McCoy said:
Hi, Laura–
Under Claim Settings overrides, the “Enable Pay-To Address” is a global setting for Pay to Address, meaning that by default all Payers will have the Pay to Address included. Do not check this box unless you want all Payers to have the same Pay to Address. Pay to Address is per provider.
On page 3 of our Kareo 5010 Compliance checklist, it discusses when to use the Pay to Address and how to configure it.
http://www.kareo.com/documents/5010-Compliance-Checklist.pdf
Thanks for writing–if you have more questions, please let us know.
Thursday, December 29, 2011 - 12:59 pm
5010 Enforcement – Are You Ready? Kareo Is! | Kareo said:
[...] review the Kareo 5010 Compliance Checklist for detailed instructions and the Getting Ready for 5010 blog post for training videos on how to make updates to the three areas mentioned [...]
Thursday, February 2, 2012 - 2:59 pm