The mandated Jan. 1 conversion to a new set of electronic claims transaction standards is not going smoothly for office-based physicians, disrupting medical groups' cash flow and creating hassles, according to the head of the Medical Group Management Association-American College of Medical Practice Executives.
MGMA-ACMPE chief calls for further delay on 5010 enforcement
In a three-page letter to HHS Secretary Kathleen Sebelius (PDF), MGMA President and CEO Dr. Susan Turney listed eight steps HHS needs to take to fix problems that began arising even before the Jan. 1, 2012 deadline HHS set for national compliance with federally mandated use of the ASC X12 Version 5010 standards.
"Should the government not take the necessary steps," Turney warned, "many practices face significant delayed revenue, operational difficulties, a reduced ability to treat patients, staff layoffs or even the prospect of closing their practice."
In November, sensing a lack of readiness for the upgrade from the Version 4010 standards then in approved use, HHS announced it would keep in place the Jan. 1 compliance deadline for the 5010 conversion, but would grant a 90-day abeyance of enforcement of its new rule.
One of Turney's eight recommendations is to push that enforcement delay even further back, to June 30. Turney also called on Sebelius to "permit all covered entities to submit and accept Version 4010 claims until at least June 30." In a third recommendation, Turney advised HHS to "closely monitor" industry readiness up to that extended deadline and take what steps are necessary even then "to ensure that transactions continue to flow and that physicians are paid."
Turney said problems are being reported "with Medicare Administrative Contractors and commercial plans." Some glitches that surfaced after Jan. 1 went undetected during systems testing before the deadline, she said. Meanwhile, help lines at MAC contractors have been swamped, Turney said.
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