5010 Logjam Means No Pay for Physicians
"It's clear that problems will not be resolved overnight," Carmel said this week.
Many physicians report not having been paid by Medicare or TRICARE since November 2011, as a result of the Version 5010 issues, according to the letter sent by MGMA President and CEO Susan Turney, MD, MS, FACP, FACMPE, to Sebelius.
As for CMS, it has little to say publicly on the issue. "HHS has a correspondence response process and CMS will be contributing to development of HHS's response," says Joe Kuchler, a spokesman for CMS, referring to a letter from MGMA. "In the meantime, MGMA's letter is considered open correspondence and we can't comment on specific issues."
While practices have contacted their MACs to receive clarification on the reason for rejected claims, they are provided with little to no information beyond a vague explanation that problems must "lie with your clearinghouse," according to Turney's letter.
Oddly enough, some practices are taking drastic action to try to circumvent the cash flow problems with electronic records. They are reverting to paper claims, Tennant says. "If they have to drop back to paper, we don't recommend it, but if that's the only way to get paid, they may have to take that step," he says. Eventually, however, paperwork may eventually lead to a further backlog of claims, and potential delays in payment.
Tennant says MGMA is recommending that physicians take their cases, if necessary, directly to CMS. "The more complaints CMS hears, the more chance they will take action," he says.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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