5010 Logjam Means No Pay for Physicians
Problems have been reported with both Medicare administrative contracts and commercial plans. Some physicians have resorted to taking out lines of credit simply to meet payroll and other expenses. No one seems to be able to pinpoint specific reasons for the cash flow problems.
American Medical Association President Peter W. Carmel tells HealthLeaders Media that over the five weeks since the 5010 standard was implemented, physicians have been "experiencing very alarming problems that have resulted in significant interruptions in claims processing and cash flow." As a result, more postponements should be made for any enforcement deadline of the HIPAA Version 5010, he says.
Recently, CMS's Office of E-Health Standards and Services (OESS) announced a 90-day period of "enforcement discretion" for compliance with the new 5010 HIPAA transaction standards. CMS extended the 5010 compliance deadline to March 2012 to allow more physician practices the opportunity to implement the new billing-coding standard without incurring penalties.
When asked about the payment issues and the CMS 5010 enforcement deadline, Carmel says: "The AMA fully expects that another extension to the 5010 enforcement deadline will be needed to resolve the emerging issues. We are reviewing timeline recommendations for an extension, but it is clear that no enforcement action should be taken until the vast majority of physicians are being paid in a timely manner under the 5010 standard."
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