5010 in 2012 - West Virginia Healthcare Financial Management

Report
Len Stusek – Senior Manager,
Pat Blech – Product Manager, is
Partner, has been in healthcare
responsible for development,
implementation and training of
the company’s Denial
Management suite of applications.
Patrick is well- seasoned in client
relations and a veteran at
speaking on such topics as 5010
and Denial Management.
IT/EDI since 1988. The last ten
years he has served to lead both
EDI Sales and Customer Service
teams with Quadax as the
Division achieved unprecedented
growth and nearly 100% client
retention.
 While some are predicting the end of the world in the
year 2012, rest assured that it will not be as a result of
the transition to 5010.
“When you arrive at a fork in the road, take
it.” Yogi Berra
5010 Transactions
 Healthcare Claims - 837 – Institutional and
Professional
 Remittance Advice – 835
 Eligibility Inquiry/Response – 270/271
 Claim Status Inquiry/Response – 276/277
 Claims File Functional Acknowledgement - 999
 Claims Acknowledgement– 277CA
Intended Purpose of 5010
 Provide the infrastructure on ICD-10 Diagnosis
Codes and Present on Admission Indicators
 Reduce redundancy and provide uniformity in
transaction structure and usage of data content
 Reduce dependency on trading partner
companion guides which many entities were
forced to rely on with 4010A1
270 & 271 Transactions
 Primary and Secondary insurance will now be
identified
 5010 version allows for a search by Member
ID, last name only or date of birth
276 & 277 Transactions
 Claim Status can be reported – Provider Level,
Claim Level and Service Line Level
 Addition of Account Number field, receive
“cleaner” responses.
999 File Acknowledgement
Previously each Medicare Administrative Contractor produces custom error
reports that varied by jurisdiction
The Functional Acknowledgement 997 is being replaced by the 999 transaction
The TA1 and 999 reflect technical problems that must be addressed by the
software preparing the EDI transmission
The 999 is output from the Translator indicating either R (Rejected), E (Accepted
with Errors), A (Accepted)
Clearing houses and software vendors can use these transactions to produce
reports tailored to their customers.
277CA Transaction
Proprietary error reporting (277U, 277R ) will be replaced with the
277CA Claims Acknowledgement transaction
Claim by claim reporting, accepted claims and returns claim
number and rejected claims with the error codes indicated in one
file.
The 277CA reflects a data problem that must be addressed by
resources in the Billing area; Billing staff will likely need reports (or
work queues) to be produced using the 277CA transaction in order
to identify claim corrections before resubmission.
5010/ICD-10 Timelines
5010 and the MACs
 MACs and CEDI will support the submission of
4010A1 and 5010 837 claim transactions in
production starting April 5, 2011 through
December 31, 2011 March 31, 2012.
 CMS grants HIPAA 5010 compliance leeway,
MGMA asks for more (additional 90 days)
Clearinghouse/Submitter role

4010 to 5010 for noncompliant
providers
 5010 to 5010 standardization?
 5010 to 4010 for noncompliant payers
5010 – The Aftermath
 837 issues/updates
 How do I navigate thru the “stuff”?
 835 issues updates
 Tips for post 5010 Denial Management
 Final Thoughts
 Questions?
From: [email protected] [mailto:[email protected]]
Sent: Monday, March 05, 2012 3:17 PM
To: Len Stusek
Subject: Kentucky Part B News from CGS
Kentucky Part B News from CGS
Version 5010 – Where Are We Now? Centers for Medicare & Medicaid Services Webinar –
Central Event Invitation: Please join the Centers for Medicare and Medicaid Services Regional
Offices for an informative webinar on Version 5010 for healthcare providers, clearing houses, vendors
and others. Read More...
http://www.cgsmedicare.com/kyb/pubs/news/2012/0312/Cope18248.html
From: [email protected] [mailto:[email protected]]
Sent: Monday, March 05, 2012 3:36 PM
To: Len Stusek
Subject: Registration Confirmation
You have registered for the following event:
EVENT INFORMATION
----------------Company: CMS
Event Title: Version 5010 - Where Are We Now? - Eastern Webinar
Event Date: Mar 6, 2012
Event Time: 10:00 AM ET
You are not registered for the webinar. Webinar and phone line capacity have been
reached. Check with the CMS website (www.cms.gov ) for future opportunities and
information. Thank you!
5010 Early implementation
 During the week of December 5-9, 2011, National Government
Services experienced processing issues with the new Part A
Common Edit Module (CEM) which has resulted in a backlog of
claims to be processed through the CEM.
 Some payers cut-over early without notice resulting in file
rejects.
 Inbound sent in 5010 format but Outbound sent in 4010
format, due to mapping issue as per 5010 specs in Loop
2010AA Billing provider name, Ref Segment, Data Element 1H CHAMPUS Identification Number
is not required but it is essential in 4010 which cause this error
“BILLING PROVIDER 2ND-ID IS INVALID”
Top Problematic Payers
 Caresource - 5010 to 4010 back to 5010
 OH Medicaid - MITS transition ahead of 5010
 MI Medicaid
 MI Blue Cross
 Aetna
 Healthplus (MI)
 Note – list does not include a WV specific payer!
“If the world was perfect, it wouldn't be.” Yogi Berra
Compliance Statistics
 Vendor Compliance
 Dec. 2011
 April 2012
50%
Projection – 75%
 Payer Compliance
 Dec. 2011
 Feb. 2012
 April 2012
30% rep. 15% volume
80% rep. 67% volume
Projection - 94% rep. 75% volume
5010 issues - General
 Claims not making it to payers
 No visibility into claim status
 Increased rejections
 Delayed/missing remits
 Vague rejections
 Degradation of support
 Some entities were reporting 10x production issues &
8x volume increase in call center activity
5010 Issues post 1/1/2012
 Edits have been updated to accept LOB indicator of "FI"
on 5010 FEP claims.
 Some payers had dark days where their system was down
and did not provide notice. No files could be sent (837’s)
or received (835’s)
 P55819_496 Submitter not approved for electronic claim
submissions on behalf of this entity
 Claims containing Occ Code 50 will reject. This is a known
issue and there is no established fix date (resolved
1/23/2012)
 WV Medicare B - has distributed both ANSI 835 files with
"T" for Test and "P" for Production in the same file.
Caused remit delay.
 Other varied and sporadic ERA (835) delays.
 Some providers were “unlinked” to established
Clearinghouse with remits going to another.
 Rejection of secondary claims that contain negative
dollar amounts - CMS has not issued a statement as to
how to report claims paid by the primary payer with
negative values, something that was acceptable under
the 40.10 guidelines.
 Invalid rejection of claims for NPIs not being registered
with the submitter. The NPI issue was resolved by the
various Medicares, affected files had to be resubmit,
which resulted in payment delays due to the “ceiling”
being reset.
 The FISS system added new DRG codes with the January
release, however these were not included in the CEM
reference file. FISS is aware of this issue and will be
correcting under PAR ZFSZ6613. There is no scheduled
release date for this issue at this time.
 *P56617 – National drug code or universal product
number : Invalid for Payer.
Crossover Claim Issues
Important Information Concerning Medicare Outreach Efforts to
Supplemental Payers Directing Their Payments to Incorrect
Addresses
 Over the past several weeks, many physician/practitioner billing
offices have notified their servicing A/B Medicare Administrative
Contractor or Part B Carrier and the Centers for Medicare & Medicaid
Services (CMS) that various supplemental payers have directed
payment, arising from Medicare crossover claims, to incorrect
payment addresses. The problem appears to have escalated as the
supplemental payers have transitioned from receipt of crossover
claims in version 4010 professional claims format to the version
5010A1 professional claims format. CMS believes it understands the
full dimension of the problem and wishes to pass along those details
to affected physician/practitioner billing offices through this article.
 http://www.cms.gov/MLNMattersArticles/Downloads/SE1212.pdf
CMS is not receiving similar complaints from institutional
providers as tied to Pay-to Address information reported
on HIPAA 5010 837 institutional production
COB/crossover claims.
Possible Cause #1:
 For HIPAA ANSI X12-N 837 version 4010A1 professional claims, Medicare's Part
B claims processing system (Multi-Carrier System or MCS) usually only created
the 2010AA loop, including the N3 and N4 segments. Since the HIPAA 4010A1
837 Professional Claims Implementation Guide had no prohibition against
reporting Pay-to Address-related information—such as Lock-Box or P. O. Box
address information, as retained within PECOS and the internal
physician/practitioner files as the physician/practitioner’s “check or remittance
address”—in the 2010AA N3 and N4 segments, the Part B claims system
created 4010A1 837 professional outbound crossovers that only contained
2010AA loop address information.
 Under HIPAA 5010 requirements, Medicare must now create a 2010AB loop,
with N3 and N4 segments, if the Pay-to Provider Address differs from the Bill-to
Provider Address. This means that the address that most often used to be
reflected in the 2010AA loop N3 and N4 address segments (which in reality was
the Pay-to Address) now has to be reflected in the 2010AB N3 and N4
segments. Now, under HIPAA 5010, the address that Medicare reflects in the
2010AA N3 and N4 loops is truly the Bill-to Provider Address (or “master”
and/or “physical address,” as captured within PECOS and the internal Medicare
files).
Conclusion tied to Possible Cause #1: Supplemental payers
with Coordination of Benefits Agreements (COBA) may
systematically still be reading the 2010AA N3 and N4 loops as
the basis for determining where to direct their supplemental
payments.
Possible Cause #2:
 The physician/practitioner’s “check or remittance address,” as
maintained by Medicare is no longer valid. As previously
mentioned, the “check or remittance address” becomes the
2010AB N3 and N4 segments on outbound version 5010A1
837 professional crossover claims.
Remedy for Possible Cause #2:
 If the address reflected in the 2010AB N3 and N4 segments is
incorrect, the physician or practitioner will need to contact its
servicing A/B MAC or carrier to have this information updated
through appropriately established procedures.
Possible Cause #3:
 There may be instances where the supplemental payer
uses the address information that it maintains within its
internal files as the basis for directing supplemental
payments to a given physician or practitioner, and that
information is out of date.
Remedy for Possible Cause #3:
 The physician/practitioner’s billing office will need to
address this matter with the supplemental payer directly
for resolution.
Crossover Claim Issues
 The COBC activates the following edits once COBA trading partners
move into HIPAA 5010 or NCPDP D.0 production:
 N22226—“4010A1 production claim received, but the COBA trading
partner is not accepting 4010A1 production claims.”
 N22230—“NCPDP 5.1 production claim received, but the COBA
trading partner is not accepting NCPDP 5.1 production claims.”
 *To review the entire CR6658, visit
http://www.cms.gov/transmittals/downloads/R1844CP.pdf on the
CMS website.
 *To review the entire CR6664, visit
http://www.cms.gov/transmittals/downloads/R1841CP.pdf on the
CMS website.
Crossover Claim Issues
 Breaking News – Friday, March 16th
 Our Part A claims processing system (FISS) maintainer
has identified a situation whereby taxonomy codes
reported on incoming version 5010A2 claims are not
reliably mapping to outbound version 5010A2
COB/crossover claims. This issue is precipitating
numerous problems for State Medicaid Agencies as well
as a small number of commercial payers.
Navigating the “stuff”
 If you have missing claims
 Claim not showing up as accepted from a 277ca

Contact Clearinghouse partner
 Claim showing as sent to payer but no payer reporting
back
 Contact payer – if the payer has no information
 Contact Clearinghouse partner
Navigating the “stuff”
 Check your provider enrollment and NPI information for
correct reporting of Billing and Servicing provider
information with each of your payers.
 Actively monitor CMS, payers and clearinghouse partner
websites for news.
 ‘In theory there is no difference between theory and
practice. In practice there is.’ Yogi Berra
Available Resources
J11 Part A Issues
Medicaid Workshops
 The WV Bureau for Medical Services (BMS) and Molina Medicaid Solutions will be conducting
seven (7) Provider Workshops throughout the state from March 26 – April 9, 2012. We are
offering the workshops at various locations to accommodate as many providers as possible.
All sessions are identical and include either a continental breakfast or an afternoon snack.
Subjects will be discussed that affect a wide variety of provider types. Please join us at this
year’s Provider Workshops so you and your staff are aware of new developments that may
impact you.
Below are the scheduled events.
 Martinsburg at Comfort Inn: March 26, 2012 9:00 am – 1:00 pm
 Morgantown at Lakeview Resort: March 27, 2012 9:00 am – 1:00 pm
 Wheeling at Oglebay Park, Pine Room: March 28, 2012 9:00 am – 1:00 pm
 Huntington at Big Sandy Arena: March 29, 2012 12:00 pm – 4:00 pm
 Charleston at Charleston Civic Center: April 3, 2012 9:00 am – 1:00 pm
 Flatwoods at Days Inn Hotel: April 5, 2012 9:00 am – 1:00 pm
 Beckley at Tamarack: April 9, 2012 12:00 pm – 4:00 pm
Medicaid Contacts
Clearinghouse Partners
Top VW Medicaid Errors – February 2012
Reporting Impact
 Claim Status Category changes remove all “Not Advised” codes
which includes pended claims. Removing the Pend/Suspend
category codes on the 835 means that Plans/Payers will now
have to report pended claims on the 277CA instead of the 835.
 New 5010 standards be implemented/delivered uniquely by
HIS/PMS, clearinghouse and individual payers. The potential
(reality) is increase is upfront edits at clearinghouse, increase
in front end rejections based on tighter edits and reporting on
277ca and increase in 835 denials do rule changes, system
changes and unintended consequences.
HIS/PMS Ability to Support 5010
 Does your host system have the ability to produce a 5010
formatted file?
HIS/PMS Ability to Support 5010
New 837- 5010 Fields
UB04
1500
Additional Diag Code Fields (25)
Additional Diag Codes Fields (25)
Additional Surgical Codes Fields (25)
Other Insured Relationship
Additional Occurrence Span Fields
Additional Line Detail Fields (prescription
date, purchased svc, purchased svc
amount, purchased npi)
Additional Physician Detail
Addition of Pay To Addresss
Service + Facility Tax Fields
Line Control Number
Remaining Patient Liability
Line Control Number
HIS/PMS Ability to Support 5010
 4010 or print image may require staff manually populate
5010 required data
HIS/PMS Ability to Support 5010
 4010 or print image may require staff manually populate
5010 required data
 Billed information may deviate from information stored in
Host System
 Time consuming labor cost
HIS/PMS Ability to Support 5010
 Inability to produce 5010 source file may
ultimately result in clearing house payer rejection
 May result in future processing issues as well
 No support for ICD10
Clearing House/Vendors Ability to
Support 5010
 Does your clearinghouse have the ability to accept a 5010
formatted file?
Clearing House/Vendors Ability to
Support 5010
 Will your vendor actively track which payers do/do not accept
5010 and transmit required format?
 5010 enforcement period begins July 01, 2012 for most
health plans
 5010 enforcement period begins January 01, 2013 for all
“Small” health plans
Clearing House/Vendors Ability to
Support 5010
 Failure to transmit required ANSI 837 version may result in
entire FILE REJECTIONS
Clearing House/Vendors Ability to
Support 5010
 Clearing House/Vendors should remain current on all payer
specific guidelines to minimize rejections
 See CMS MLN Matters® Number: SE1137
Clearing House/Vendors Ability to
Support 5010
CMS MLN Matters® Number: SE1137
As COBA supplemental payers move into production on the
5010A1 and A2 claim formats, CMS requires that they
continue to accept their “pre-HIPAA 5010” production Version
4010A1 claims for 14 full calendar days after their cut-over to
the new claim formats.
Clearing House/Vendors Ability to
Support 5010
CMS MLN Matters® Number: SE1137
For a limited timeframe (likely 30 days after a supplemental
payer cuts over to Version 5010 for crossover claims receipt),
providers, physicians, and suppliers will need to file the
affected claims directly with their patients’ supplemental
payers.
CMS MLN Matters® Number: SE1137
 During the 90 day non-enforcement period (January 1, 2012—
March 31, 2012), Medicare will have the systematic capability to
convert incoming claim formats in accordance with external
supplemental payer specifications concerning production claims
format. That is, Medicare will have the ability to:
 Take incoming claims submitted by the provider community in
hardcopy (paper) format or Version 4010A1 or NCPDP 5.1 batch
claim formats and convert them to HIPAA Version 5010A1 or
5010A2 claim formats, as appropriate, or NCPDP D.0 batch claim
formats for those COBA supplemental payers that already have cutover to exclusive receipt of Version 5010 COB claims in production;
and
 Take incoming claims submitted by the provider community in the
Version 5010A1 or 5010A2 or NCPDP D.0 batch claim formats and
convert them to HIPAA Version 4010A1 claim formats or NCPDP 5.1
COB batch claim format for those supplemental payers that have
not cut-over to production use of the HIPAA Version 5010 COB claim
formats or NCPDP D.0 batch claim format.
Clearing House/Vendors Ability to
Support 5010
 Failure to monitor payer guidelines and claim processing
habits may result in file rejections, claim rejections,
suspensions or denials!
Payer Edits Updated to Require
5010 Data
 Discharge Hour Prohibited on OP Claims
 ICN# Required on XX7 + XX8 bill types
 Legacy numbers prohibited when NPI is present
 Provider + Pay-To zip must be 9 digits
Payer Edits Updated to Require
5010 Data
 Payers will reject claims if 5010 specific fields
are not provided or complete!
Updated Payer EDI + Editing
Systems with 5010 Conversion
Updated Payer EDI + Editing
Systems with 5010 Conversion
 Many payers are updating Editing, EDI Systems + Processes in
Line with 5010 Conversion
 Conversions are directly resulting in:
 increases in rejected, suspended and denied claims
 Erroneous/missing claim status updates
Updated Payer EDI + Editing
Systems with 5010 Conversion
CMS will be making system improvements concurrent with the
5010/D.0 changes. These improvements include:
 Implementing standard acknowledgement and rejection
transactions across all jurisdictions;
 Improving claims receipt, control, and balancing procedures;
 Increasing consistency of claims editing and error handling;
 Returning claims needing correction earlier in the process;
and
 Assigning claim numbers closer to the time of receipt
Updated Payer EDI + Editing
Systems with 5010 Conversion
Medicare Conversion to 277CA Response Reports
Medicare - Proprietary error reporting will be replaced with
the 277CA Claims Acknowledgement transaction across all
MACS
Updated Payer EDI + Editing
Systems with 5010 Conversion
Medicare CEM
The CEM software will perform Medicare specific edits,
CMS-selected IG edits and produce the following: CMS flat
files for accepted transactions, with claim numbers
assigned, A 277CA for each accepted or rejected claim, The
277CA for an accepted claim will contain the claim number
Updated Payer EDI + Editing
Systems with 5010 Conversion
Collateral Damage
•Claim Rejections
•Claim Suspensions
•Delayed Processing Times
•Missing Claim Status Responses
Updated Payer EDI + Editing
Systems with 5010 Conversion
Collateral Damage
Example Rejection
Rejection Message Returned - INFORMATION SUBMITTED
INCONSISTENT WITH BILLING GUIDELINES
Response Time – 15 Days
Resolution – Edit is erroneously affecting claims at the MACS. The
edit will be relaxed with a system upgrade in April
Updated Payer EDI + Editing
Systems with 5010 Conversion
Collateral Damage
Example Rejection
Rejection Message Returned - FISS REASON CODE 10139: DATA ELEMENTS ON
THE EMC CLAIMS RECORD EXCEEDED THE FIELD SIZE FOR THE CORRESPONDING
UB-92 ON-LINE CLAIMS FORMAT. THEREFORE, AMPERSANDS WERE MOVED TO
THE ASSOCIATED FIELD.
Response Time – 30+ Days
Resolution – Edit is erroneously suspending claims in FISS. Initial explanation
detailed that invalid characters were populated in claim file. MACS advised this is
an issue with FISS and are working on a resolution
Support Limitations with 5010
Conversion
•Per MGMA letter to CMS regarding 5010 issues:
“Protracted call hold times (most typically 1-2 hours) when
attempting to contact MACs for further explanation of unpaid
and rejected claims”
•Some Vendor support has declined due to influx of 5010
related issues
Consider All Available Sources of
Payment Delay
Pre-Bill
Errors
Payer
Rejections
(277 Files)
Payer
Remits
(ANSI 835)
Consider All Available Sources of
Payment Delay
A majority of 5010 related issues occur pre-adjudication
Consider All Available Sources of
Payment Delay
HIS/PMS + Clearinghouse Edits
Rejection Message Returned - Claim contains a non compliant
P.O Box format per 5010 requirements
Resolution – Host system must be updated to supply compliant
address information or staff must manually update
Consider All Available Sources of
Payment Delay
 Payer Front-End Rejections
Rejection Message Returned - ACK/REJECT INVAL INFO - entity
street address - billing provider
Resolution – Billing provider address must be a street address or
physical location. PO BOX should be sent in the pay to address if
needed
Consider All Available Sources of
Payment Delay
 Medicare FISS Rejection
Rejection Message Returned - 10139: DATA ELEMENTS ON
THE EMC CLAIMS RECORD EXCEEDED THE FIELD SIZE FOR THE
CORRESPONDING UB-92
Resolution – MAC’s and FISS working to resolve this issue
Consider All Available Sources of
Payment Delay
 Remittance Denials
Rejection Message Returned – 15 -The authorization number
is missing invalid or does not apply to the billed services or
provider
Resolution – MAC claim processing system not reading the
entire auth number from 837 file
Consider All Available Sources of
Payment Delay
 Remittance Denials
Rejection Message Returned – 18 –Duplicate Claim/Service
Resolution – 5010 file transmission issues between payer +
clearinghouse may result in duplicate file transmissions
Identify + Workflow
Once identified, all rejections should be automatically
workflowed to staff worklists for timely review and follow-up
Rejection
Source
Workflow
System
Engine
Report 5010 Denial Impact
Providers should report 5010 related rejection/denials to better
understand the impact of 5010 conversion and to support
resulting assumptions with live data
Report 5010 Denial Impact
Letter from MGMA to CMS
Version 5010 Issues and Concerns
Physician practices have reported numerous problems across various areas of the United States stemming
from the transition to Version 5010. The most frequently reported problems have involved:
• Issues with practice management and/or billing systems that showed no problems during the testing phase
with their MAC, but once the practice moved into production phase, found their claims being rejected
• Issues with secondary payers
•Rejections due to various address issues (pay-to address being stripped/lost from claims; pay to address can
no longer be the same as billing address; no PO Box address)
• Crosswalk NPI numbers not being recognized
• “Lost” claims with MACs
•Certain "not otherwise specified" claims being denied due to not having a description on the claim (CMS sent
a notice of correction of this issue Jan. 27, 2012)
•Unsuccessful claims processing (with no reason cited for rejection) despite using a “submitter” that was
approved after successful testing with CMS
Report 5010 Denial Impact
Step 1: Gather listings of Rejections/Denials from all
available sources and identify specific codes related to 5010
5010
related
Non-5010
related
Report 5010 Denial Impact
Step 2: Identify Root Cause (Responsible Party) For 5010 Related
Rejections + Denials
 This may be time consuming, but end result will be
worthwhile
Report 5010 Denial Impact
Rejection/Denial
Root Cause
Pre- Bill Edit “non-compliant P.O Box format per 5010
requirements”
Provider
Pre-Bill Edit “non-compliant patient relation code
Vendor (HIS)
Payer Rej “ACK/REJECT INVAL INFO - entity street address billing provider
Vendor (Clearinghouse)
Payer Rej “INFORMATION SUBMITTED INCONSISTENT
WITH BILLING GUIDELINES
Payer
Remittance Denial “15 - The authorization number is Payer
missing invalid or does not apply to the billed services
or provider”
Remittance Denial “ 18 – Duplicate Claim/Service”
Vendor (Clearinghouse)
Report 5010 Denial Impact
•Pre- Bill Edit “non-compliant P.O Box format per 5010
requirements” – PROVIDER
•Pre-Bill Edit “non-compliant patient relation code” – Vendor
(HIS)
•Payer Rej “ACK/REJECT INVAL INFO - entity street address billing provider” – Vendor (Clearinghouse)
•Payer Rej “INFORMATION SUBMITTED INCONSISTENT WITH
BILLING GUIDELINES – Payer
•Remittance Denial “15 - The authorization number is missing
invalid or does not apply to the billed services or provider” - Payer
Report 5010 Denial Impact
Step 3: Format and compile data into meaningful reports
Report 5010 Denial Impact
Once rejection/denial data is identified and categorized, it can be used to:
•More accurately gauge resource and financial impact of 5010 claim
processing issues
•Identify sources causing greatest impact
•Quickly produce live examples to backup assumptions (Data is King)
Report 5010 Denial Impact
CMS Financial Preparation Advice
https://www.cms.gov/ICD10/Downloads/SmoothTransition.pdf
 Establish a line of credit. Providers should work with their
financial team to establish or increase a line of credit to cover
potential cash flow disruptions. A line of credit will help a
provider’s practice prepare for potential delays and denials in
payer claims reimbursements due to noncompliant Version
5010 transactions being submitted. A practice should also
evaluate its cash reserves.
‘”f
you ask me anything I don't know, I'm not going to answer.”
“I wish I had an answer to that because I'm tired of answering
that question. Yogi Berra
I just want to thank everyone who made this day necessary. Yogi Berra

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