Ready for 5010?

The switch from the old electronic data standard ANSI 4010 to the new ANSI 5010 format is just six months away and National Testing Day has come and gone. Every major carrier has a web post, page, or journal outlining their schedule for testing and when they will be ready.  That sounds great in theory, but the reality is somewhat different. Most billers are ready and waiting on the carriers, and the carriers are not testing with them.

One billing company has a web page that shows testing status for all of their payers, including those under clearinghouses. Approximately 2,275 carriers and Third Party Administrators (TPAs) are listed. A grand total of fifteen non-governmental carriers are tested and approved. This indicates that there is going to be a mad rush to test in the latter half of the year straining IT resources and leaving little time for problem resolution.

Cigna states on its website that it would test from June through August of this year, using post-n-track.com to log progress. Last update: May 4, and nothing is indicated at this time in testing. Aetna is currently testing; many other carriers are not advertising where they are in the process.

Do not expect a delay of the compliance deadline. ANSI 5010 is an important and necessary precursor to the ICD-10 transition in 2013. The Centers for Medicare & Medicaid Services (CMS) have made it clear that there will be no extensions.

Claims may be delayed if your biller and the carriers are not ready. Make sure your practice is ready for the switch. Talk to your biller about their readiness and the carriers they work with and make sure they have a game plan in place.