Wiki 5010- bc

sbarrila

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We bill for several ASCs throughout the US. We are finding that many of our BC carriers are having issues with the 5010 version. We submit our claims via Zirmed and we are being informed that they are accepted by the payer only to find that the intermediary is not actually able to send the claims through. Is anyone else finding issues with their 5010 submissions/clearninghouse? Thank you.
 
Zirmed 5010

going through the same thing here in ohio for my asc , only not with bc, we are seeing the issue with medicare. Are you having any with yours? We too are using zirmed, we are having issues with claims that are dated 1-9 to 1-12, zirmed notified us yesterday of this issue, dont know if there is anything we can do as providers?

I dont think anyone was ready for 5010, especially the insurance companies lol, typical lol

Any input or thoughts would greatly be appreciated
 
I have not had any issues with any of the Medicare carriers and 5010. We had a conference call with one of the managers at Zirmed today and there are so many issues that they are not even aware of... If I learn anymore I will let you know.
 
I"ve ran into alot of problems with the 5010 for our medicare patients, apparently there is a whole list of codes that requires a detailed description of the service written on the claim. So upon contacting the medicare EDI department (only after several calls and waiting on hold for OVER an hour) they gave me a loop and segment number that I was to give to give to my software engineer so they can adjust it.

Well of course my software people have no idea what im talking about and advised me to contact Medicare and have them send exact programming! So now im back trying to get intouch with Medicare and my claims are waiting in limbo!
 
Medicare issues as well as others

We are having the same problem here in Alabama. Haven't received funds -- just deductible and denials from Medicare since December. What little is coming from BCBS we have submitted 4 or more times to finally get it to go through. I'm using AdvancedMD (don't recommend them) and they go through RelayHealth to submit. Supposedly their "testing" showed no issues but my world blew up January 9th. Struggling to stay sane here.

Yes there is an NDC requirement and certain codes (J3301) require more description. However, my software now requires more fixes on my payments -- something about it not equalling? -- that require more info before I can send them to the secondary or they get denied. Have never had to do this much work to just transmit claims and getting paid is a battle.

Also getting Medicare denials stating they've already paid the claim and duplicate claims for claims that we have not been paid on.
 
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