Home Health & Hospice Week

The message: If you want to avoid a cash flow crisis, talk to your vendors and clearinghouses now -- don't wait until January, advised Denise Buenning with the Centers for Medicare & Medicaid Services during the call.

An American Academy of Ophthalmology representative called into the forum and noted that several of her association's members were told by their vendors that they will not be ready by the deadline.

"There are a number of risk mitigation strategies that I think folks should be looking at right now," Buenning said. "One is, I've heard that some of the provider organizations are advising their members to try and get a majority of their claims in prior to Jan. 1 and then just kind of ride out the next 30 days or so as the dust clears, so to speak."

"Obviously, employing the services of a clearinghouse is always an option," Buenning added. "If you're a Medicare fee-for-service provider, you can get the free software that Medicare makes available, downloaded from the MACs," she said.

"Another option ... is for the provider to get a line of credit from their local financial institution or bank to make sure they're covered on their cash flows," she said.

The best option, Buenning said, is to "Contact your payers and find out how they're going to help the providers mitigate their risks and make sure their claims are going to continue to be paid."

If your home care organization of ten or fewer employees has been sweating the 5010 form conversion, you might be able to breathe easier, CMS reps said during the agency's Sept. 14 National Provider Call regarding HIPAA 5010.

A caller to the forum indicated that she's with a small provider that submits paper claims, and asked how she can logistically convert to 5010,which prompted a reaction from CMS that surprised several listeners.

The facts: Small providers with less than ten employees may fall under the "ASCA (Administrative Simplification Compliance Act) waiver,"which means they "technically will still be able to bill the 1500 [form]," said CMS's Aryeh Langer during the call. Therefore, the conversion to 5010 "will have little impact, if any," to these small providers, he added.

CMS defines "small providers" as those with less than 10 full-time employees. Those providerscan apply for the ASCA waiver, which would preclude them from having to file electronically. To apply for an ASCA waiver, visit www.cms.gov/ElectronicBillingEDITrans/07_ASCAWaiver.asp or your MAC's Web site.

Keep in mind: Small providers will still be expected to report ICD-10 codes -- the waiver will  not excuse them from switching from ICD-9 to the new system on Oct. 1, 2013. However, an approved ASCA waiver will allow those providers to keep using the CMS-1500 form instead of electronically reporting the 5010.