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Indiana’s Medicare carrier comments on delayed enforcement of 5010
Dec. 21, 2011
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In response to the Centers for Medicare & Medicaid Services (CMS) announcement of a 5010/D.0 a discretionary period for enforcement (see the Dec. 19 ISMA Reports), National Government Services (NGS) advised it is taking the following actions:

Part B Providers and trading partners

  1. Beginning Jan.1, 2012, trading partners approved for 5010 production will have 30 days to complete their production migration.
  2. Trading partners that have not begun 5010 testing by Jan. 1, 2012, will have 30 days to submit a testing plan and timeline. Physicians and other providers should note that that March 31, 2012, is the last receipt date electronic transaction will be processed in the 4010 format.

Part A (including, home health, hospice and federally qualified health centers) trading partners

  1. Beginning Feb. 1, 2012, trading partners approved for 5010 production will have 30 days to complete their migration.
  2. Part A trading partners that have not begun 5010 testing by Feb. 1, 2012, will have 30 days starting Feb.1, 2012 to submit a testing plan and timeline. March 31, 2012, is the last receipt date electronic transactions will be processed in the 4010 format.

All files with receipt dates after March 31, 2012 must be submitted in the Health Insurance Portability and Accountability Act (HIPAA)-compliant 5010 format. Please watch for a follow-up communication with instructions for submitting the test plan and timeline.

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