Attention All Providers and Trading Partners!
The deadline for submitting transactions in the HIPAA 5010 format was January 1, 2012. Montana Health Care Programs has been allowing the submission of 4010 transactions to give providers extra time to make the transition but will stop accepting them as of 9:00 p.m. MST on Tuesday, January 31, 2012. This includes the 270/271 Healthcare Eligibility Benefit Inquiry and Response, 276/277 Healthcare Claim Status Request and Response and the 837P (Healthcare Claim: Professional), 837D (Healthcare Claim: Dental) and 837I (Healthcare Claim: Institutional) transactions. If you send a 4010 transaction after the date and time, it will not be processed. You will see an error message on your confirmation report.

The 835 Claim Payment/Advice transaction will be sent in the 4010 format for the last time for the January 30, 2012, paid date. Beginning with the February 6, 2012, paid date, the 5010 835 transaction only will be delivered to all trading partners.

If you submit claim transactions using ACS’ free billing software, WINASAP, you must download the new 5010-compliant version and begin using it as of February 1, 2012. The software and user manual are available at http://www.acs-gcro.com/docs/edi-winasap5010.php?menuItem=default.

If you use other software, contact your software vendor and/or clearinghouse to make sure they are aware of the January 31, 2012, deadline.

Contact Provider Relations at 1-800-624-3958 with any questions.

 

MATH Web Portal and Production HIPAA 5010 Files

Attention All Providers: For those of you who use the MATH web portal to upload 837P, 837D, 837I, 270, or 276 batch transactions, the functionality is now available for production HIPAA 5010 files. The corresponding 999, 277CA, 271, and 277 response files can also be retrieved on the MATH web portal. We apologize for the delay in making this functionality available.

All other submission methods continue to be available for both HIPAA 4010 and 5010 files. Montana Health Care Programs will accept these transactions in the HIPAA 4010 format through December 31, 2011, but beginning January 1, 2012, transactions submitted in the HIPPA 4010 format will no longer be accepted through the MATH web portal or any other submission method.

Please contact ACS Provider Relations at 1-800-624-3958 or 442-1837 if you have any questions or have problems submitting or retrieving files.

 

HIPAA 5010 Update
Montana Health Care Programs began accepting production 5010 transactions on December 1, 2011.

All 5010 transactions (837I Health Care Claim: Institutional, 837P Health Care Claim: Professional, 837D Health Care Claim: Dental, 270 Eligibility Inquiry Status and 276 Claim Inquiry Status) received between December 1, 2011 and December 7, 2011, were released for processing on December 7, 2011.

If you submit 5010 transactions between December 1 and December 7, 2011, and have not received the appropriate response files (999 Implementation Acknowledgment, 277CA Claim Acknowledgement, 271 Eligibility Inquiry Response or 276 Claim Status Response) contact Provider Relations.

Claims submitted electronically were processed through MMIS on December 7. Transactions submitted after December 7 will be processed immediately upon receipt.

All electronic transactions must be submitted in the 5010 format on and after January 31, 2012; any transactions submitted in the 4010 format on or after this date will not be processed.

Contact Provider Relations (800-624-3958 or 406-442-1837) if you have any questions.

5010 WINASAP Production Version Now Available
The 5010 production version of ACS’ free claims billing software, WINASAP, is now available.

Test versions of the database are no longer available, but you can send test claims using this version by clicking the radio button for Test under the Tools/Send Claim File option.

The software and user manual are available at:
http://www.acs-gcro.com/docs/edi-winasap5010.php?menuItem=default

This is the single install of the WINASAP 5010 database; it will be a separate application from your current WINASAP2003 database.

There are instructions in the manual for installing the new software as well as for converting your 2003 database into a 5010 database, if desired.

It is not necessary to do this but if you do not, you will be required to enter the patients, providers, taxonomy and other reference data into the 5010 database before you can create any claims.

If you have issues or questions with downloading, installing or using the software, please contact ACS Provider Relations at 1-800-624-3958 or via e-mail at MTPRHelpDesk@xerox.com.

Remember, the deadline for sending 5010-compliant transactions is January 1, 2012, which is less than a month away!

Meeting Timelines for ICD-10 and HIPAA 5010

For detailed timelines of activities that providers, payers, and vendors need to undertake to prepare for Version 5010 and ICD-10, download the timeline widget to your desktop or mobile device. Printer-friendly versions of the Version 5010 and ICD-10 widget compliance timelines are available for large providers, small providers, payers and vendors. The widget and timelines are public domain. CMS encourages organizations to distribute them widely through posting to websites and other channels.

11/07/2011 HIPAA 5010 FAQs

Electronic Transaction Instructions for HIPAA 5010 (05/18/2012)

• 02/19/2013 Montana Medicaid HIPAA Operating Rules Upgrade
• 12/12/2011 Qualifier for Anesthesia Services on HIPAA 5010 837P Transactions
• 11/07/2011 Provider Information on HIPAA 5010 837 Health Care Claim Transactions
• 11/04/2011 Meeting the Requirements of HIPAA 5010 When Reporting National Drug Codes on Electronic 837I and 837P Transactions (11/16/2011)
• 08/25/2011 CSCT Team Number on 5010 Electronic Claim (837P) Transactions
• 07/01/2011 HIPAA 5010/OCR Qualifier Changes Effective January 1, 2012 (09/2011)