5010 Migration and Testing - hipaa cow
5010 Migration and Testing - hipaa cow
5010 Migration and Testing - hipaa cow
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<strong>5010</strong> <strong>Migration</strong> <strong>and</strong> <strong>Testing</strong>:A Panel DiscussionPresented by:Rick Hammes, WEA TrustJoe Makowski, Optum InsightMelissa Bruechert, Holy Family Memorial IncA little about Holy FamilyMemorial Inc:• Roughly 70 providers• Average claims per month is 16,500• Claims submitted to payers viaNetwerkes• Utilizes SUPER formatWhere HFM is at withregards to <strong>5010</strong>:• Currently still testing• Test file submitted to Netwerkes• Working through the errors with PMsystem analyst1
Netwerkesnow part of OptumInsight• Joseph Makowski• Manager EDI, 5 years• Senior IT Analyst, Provider• <strong>5010</strong> Product Owner, NetwerkesNetwerkes Overview• Healthcare Clearinghouse• H<strong>and</strong>les Claims (I,P,D), Remit, CSI,Eligibility, Inpatient Notifications, BillingStatements• Averaging 3 mil plus transactions / month• 77% ANSI, 21% Print Image, <strong>and</strong> 1%Custom Claim File Format SubmittersWhere Netwerkes is atwith regards to <strong>5010</strong>:2
Things you can do tomake testing work• Communicate with your Trading Partner don’t makeassumptions.• Run your test file through a HIPAA Compliance Toolbefore sending the file to your trading partner. If morethen 20% of your records have a HIPAA Complianceerror, don’t send it to your trading partner.• Make sure your vendors are fixing HIPAA issuespromptly. We only have 10 weeks left to get intoproduction.• For the 837 transaction, make sure your billing <strong>and</strong>pay-to loops are populated correctly to preventrejections <strong>and</strong> payments going to the incorrectlocations.• KEEP COMMUNICATING3
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