Even though the MGMA has called today for an extension of the 5010 enforcement delay to June 30, 2012, we recommend that you be ready now since many payers are requiring use of 5010. Unless HHS decides to accept the MGMA’s recommendation, enforcement of 5010 will start on schedule on April 1. And if you’re using Kareo, you are ready as long as you’ve taken some key steps.
Unlike traditional medical billing software, Kareo’s cloud-based technology allows for rapid updates to comply with industry changes – like 5010 – with little or no impact on the customer experience. Most of the changes have already taken place behind the scenes. However, there are a few things Kareo customers should have done to ensure their claims are process smoothly. If you haven’t already, check to make sure the items below have been updated in your Kareo accounts:
- Update 5 digit zip codes to the full 9 digit zip codes.
- Add physical addresses to replace PO Boxes.
- Enter a new “Pay to Address” if you currently receive payments at a PO Box or a lockbox.
Please 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 above.
A few questions on 5010 that we’ve received through our blog include:
Q: Does the 9 digit zip code also need the slash after the 5th digit before inputting the last 4 digits and do all of the insurance companies have to have physical address’s rather than PO Box’s?
A: Here is what our 5010 expert advises:
Customers can include the dash but it is not required for the claim to process. Insurance company plan addresses can be a P.O. Box, also the 9 digit zip code requirement is not required for Insurance company addresses or Patient addresses
Q: Do I need to update patient’s address to 9-digit zip codes too?
A: The patient’s addresses do not have to be 9 digits.
Q: Am I correct in my understanding that I do not need to update my zip codes for all my insurance companies?
A: Zip codes for the insurance plans or companies do not have to be 9 digits.
Q: Do I need to change all patient PO box address to a physical address?
A: No, patient addresses are not affected by any 5010 changes.
Q: Will the system eventually populate all zip codes with the 4 digit codes?
A: 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.
Q: 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.
A: 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.
Q: 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?
A: 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.
Q: 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.
A: 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.
Routine customer communications will keep you up-to-date with our 5010/ICD-10 progress. We encourage customers to ensure they are thinking ahead to the bigger ICD-10 transition by October 1, 2013.
If you have additional questions, please feel free to contact us at Support@Kareo.com, via the Comments section of this blog, or on our Facebook page.
