Home Health & Hospice Week

If you haven't tested the 5010 claim format yet, you'd better be getting your transition plan together to submit to your HHH MAC.

"Submitters who have not tested ... will have until April 1, 2012 to complete their transition to the 5010 formats," the Centers for Medicare & Medicaid Services says in a recent question-andanswerelaborating on its new deadline requirements for the 5010 claim format (see Eli's HCW, Vol. XXI, No. 1, p. 6).

The catch: But that's only if they submit a 5010 transition plan within 30 days of the Medicare Administrative Contractor's request, CMS notes in the Q&A. If not, "Medicare FFS may direct the MACs to reject 4010 claims," the agency warns.

That hasn't actually come to pass, however. "The MACs have not been directed to reject 4010 claims at this time," CMS admits.

Some MACs may make it easier for you. Although CMS says in the Q&A that it won't be furnishing a transition plan format, HHH MAC subcontractor National Government Services has posted an online six-question tool to help providers formulate a plan.

Home health agencies and hospices served by NGS must submit the online form by March 2 if they haven't tested 5010 by Feb. 1, the MAC directs in a recent message to providers. NGS's form is at www.surveymonkey.com/s/LQ92QCD.

CMS merely says that in the plan, "Submitters should outline the steps they have taken and the steps they still need to take to successfully achieve compliance with the updated version of the transactions," according to the Q&A at www.cms.gov/Versions5010andD0/Downloads/QandA_for_90_day_announcement.pdf.