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Send HIPAA 5010 Claims to NC Medicaid

Send HIPAA 5010 Claims to NC Medicaid

The Centers for Medicare and Medicaid Services (CMS) is underway with implementation activities to convert from Health Insurance Portability and Accountability Act (HIPAA) Accredited Standards Committee (ASC) X12 version 4010A1 to ASC X12 version 5010. NC Medicaid has announced that they are ready for submissions in 5010 format. You may have received an email from NC Medicaid indicating that you are approved for sending claims in 5010 format.

How to test 5010 claim format in Barnestorm:
**Note that there must be claims ready to bill for NC Medicaid in order to run the 5010 billing test.**

Go to Codes > Program Related Codes > Payers. Pull up your NC Medicaid payer.
Click on the Electronic Claims Setup tab.
Change the HIPAA version to 5010.
Click the Save Electronic Claims Setup button.
Build and send a few small claims as you normally do. (This will not update the tracking, and will not generate claims to print.)
Go back into the Electronic Claims Setup tab and change back to 4010.
When you get paid for the 5010 claims, repeat steps 1-4. You will send all NC Medicaid claims in 5010 format from that point on.
If you have questions about the 5010 changeover in general, please reference the CMS site or our other Barnestorm articles on this topic. We are running 5010 testing for all of our customers, so we appreciate your patience and resourceful use of abundantly available information.

Please do not call Barnestorm with general questions about 5010. Keep in mind that this switchover is not mandatory until January 1, 2012.
Below are resources for that information, and there are several other sources online and with other payers. You can google HIPAA 5010, as well.

More information is available on CMS at:
https://www.cms.gov/ElectronicBillingEDITrans/18_5010D0.asp

More information is available on Barnestorm at:
http://kb.barnestorm.us/KnowledgebaseArticle50672.aspx

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Tags:

5010, HIPAA 5010, Medicaid