AMA Wire

Wednesday, March 7, 2012

Practice News

HIPAA version 5010 grace period to end March 31

The 90-day grace period for enforcement of the Health Insurance Portability and Accountability Act (HIPAA) version 5010 expires in a few weeks, but some physicians are still experiencing claims processing issues.

Since the Jan. 1 deadline to convert to version 5010 electronic transactions, some physicians have reported claims processing problems that are resulting in payment delays. The AMA has been working with the Centers for Medicare & Medicaid Services (CMS), state medical associations and individual physicians to help resolve these issues.

If you're experiencing claim payment delays or other claims processing issues, complete an online form to report them to the AMA. Or, file a complaint with CMS.

Here are some additional steps to take:

  • If you use a billing service or clearinghouse, ask them to explain why the problem is occurring.
  • If you submit claims directly to the payer, ask the payer to identify whether there is a problem with the data you submitted or with the payer's system.
  • If you are experiencing problems with your practice management system, contact the vendor to resolve those issues.

Read more in a recent AMA Practice Management Alert, and sign up to receive these timely email alerts.

Plan ahead to avoid 2013 ePrescribing penalty

June 30 is the deadline for eligible physicians to participate in the 2013 Medicare ePrescribing program or file for a hardship exemption to avoid the monetary penalty next year.

Read a newly updated flier from the AMA to learn more about the program, including:

  • 2012 and 2013 penalty and incentive amounts.
  • 2013 reporting requirements.
  • System requirements.
  • Applying for an exemption.

A separate flier outlines the steps to apply for a hardship exemption. If you have difficulty accessing the online exemption application, email QualityNet, which runs the portal for the Centers for Medicare & Medicaid Services.

For physicians who are able to start ePrescribing, the "Clinician’s Guide to ePrescribing" explains the process of adopting this technology and using it effectively in their practices.