In our last newsletter we indicated that APS was leading the industry in the preparation for ANSI 5010 implementation in January, 2012. Note that although enforcement of the provisions under HIPPA and HITECH relating to ANSI 5010 has been delayed until April 1, 2012, compliance with the provisions is still slated for January 1, 2012, meaning that you don’t have to have been successful but you have to show that you made a “good faith” effort to comply. As we have continued our efforts to work with payers, we have found that many of the commercial carriers and providers remain unready for the mandated switch over.
APS is currently able to produce files in both the new and old formats. Regardless of the readiness of an individual carrier we are prepared to submit claims in either fashion and can switch between the two formats quite easily. We do however want to continue to push for the adoption of the ANSI 5010 format as soon as possible. The key is that the new format gives insurers less leeway to have carrier specific denial codes, etc. enabling APS to more efficiently sort such items as denials for swift action in appeals or requests for reconsideration or to submit corrected claims if necessary.
APS will continue to push for implementation of the format with our carriers and will alert our clients to specific issues which may impact them.
In working through the wide variety of billing arrangements, APS found payments that we had been missing.