Medicare now sending all RA in 5010 format

August 31, 2012

Effective Aug. 1, 2012, the Medicare Fee-for-Service program is issuing all electronic remittance advice (RA) to health care practitioners in the new X12 Version 5010 software format, according to the U.S. Centers for Medicare & Medicaid Services (CMS).

That means health care practitioners who have not yet converted their practice software systems from the old Version 4010 to the new Version 5010 format may not be able to open and read their Medicare remittance advice to review payments, adjustments, and denials, or even post payments to patient accounts, the CMS noted.

Any health care practitioners who have not yet converted their office software to the 5010 format should do so, the CMS advises. Those who utilize a claims clearinghouse or billing service, and have not checked already, should ensure the service has implemented 5010 software.

Practitioners who begin experiencing problems in opening or translating Medicare remittance advice on or after Aug. 1 should contact their software vendors, clearinghouses, or billing services, before contacting area Medicare payment contractors about the problem, the CMS said.

Any billing staff or representatives who make inquiries related to Medicare payment on behalf of a practitioner will need a copy of the practitioner’s remittance advice, the CMS noted.

For additional information on Medicare’s conversion to the Version 5010 software format, see the AOA website 5010 page (www.aoa.org/5010).

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