Every
clinical lab is about to learn whether the transition to form
5010—required as of January 1, 2012—will be handled
flawlessly by payers or not.
Ideally,
clean claims should mean that payers send timely remittances to
your lab. But things are less than perfect. Certain payers have
already admitted that they weren’t 100% ready for form 5010
implementation on January 1. And in the days since, other payers
have struggled to process claims in a timely fashion. Even your
own lab’s billing and collections department probably already
has stories to tell about unexpected payer glitches.
Join
THE DARK REPORT and DarkDaily.com held on Wednesday,
January 18, 2012 and listen as two nationally prominent
experts on billing and collections give you up-to-the-minute
news and intelligence about the successes and setbacks payers
are having with form 5010 implementation.
The
timing couldn’t be better, because you’ll have a front-row
seat to hear the latest developments in how payers are handling
5010 implementation. You’ll learn which payers are processing
5010 claims in an exemplary fashion. But you’ll also find
out which payers have been overwhelmed by the transition—along
with tips that can help your lab avoid these issues when it files
its own claims with these payers.
First
up is Lâle White, CEO at XIFIN, Inc. Last year, XIFIN submitted
more than one million 5010 live claims for their lab clients and
found a number of problem areas. White will provide an in-depth
review of those problems as well as what your lab can do to avoid
them. You’ll also learn what’s being done to resolve
these problems going forward.
“Don’t
underestimate the importance of having in-house expertise to
help you identify, investigate, and resolve problems,”
says White. “Because if a claim is rejected, you won’t
necessarily know why.” Find out what tools you’ll
need to ensure that 100% of claims can be reconciled and errors
can be easily found—and resolved.
Next
you’ll hear from Jackie Griffin, Director, Client Services
for Gateway EDI. She’ll talk about Gateway’s experiences
with how different payers are handling 5010 claims. As one of
the nation’s fastest-growing electronic data interchanges
(ED), Griffin’s company serves 90,000 providers and submits
claims to more than 3,000 payers.
Griffin
will share an insider’s perspective of the good, the bad,
and the ugly of how payers are coping with 5010 claims. You’ll
understand the essential elements to making your lab’s claims
“clean and compliant” at first submission. You’ll
also learn specific things to avoid, as well as how to quickly
recognize payers with problems in their 5010 implementation program.
As
you know, the 5010 form requires new information from providers
that wasn’t included on form 4010. What these new requirements
are—and how to interpret data that might be returned if
there are problems with your submissions—will be critical
for getting your lab claims reimbursed without delays in the process.
Adding
confusion about how and when to use the new 5010 form is that
some payers aren’t ready to accept it. And those that are
may not be equipped to handle the massive number of new forms,
which will cause further delays in claims processing and payments.
But the reality is that it’s your lab that is ultimately
at risk for claims denials or delays. Not knowing the ins and
out of the new form and how to use it correctly poses a considerable
threat to your bottom line.
Despite
the testing delays at CMS, there has been no delay in transitioning
to the new form. CMS did announce a grace period on penalty enforcement
through March, but some payers are still insisting on the 1/1/12
cutover. So it’s critical that your lab start using—and
understanding how to use—form 5010 now.
To
make sure you’re on top of the new form and aware of the
problems that could seriously affect your revenue stream, you
won’t want to miss the latest audio conference from THE
DARK REPORT and DarkDaily.com, “HIPAA Form 5010
Implementation: Real-World Solutions to Ease the Transition
from 4010 to 5010 and Avoid Reimbursement Delays.”
Listen as two experts who have first-hand experience with the
new form provide details on the best strategies for being in
compliance with its use. You’ll get practical, real-world
insights and advice based on the results of comprehensive testing
in the last year.
Keep
in mind that the initial testing covered the design of the new
form, not the actual data. So providers can expect to encounter
additional problems when they start using 5010 on January 1st.
With almost three weeks of experience submitting live claims on
the new form, both speakers will have new insights to share, including
specific payer problems and what you can do to overcome them.
This is truly up-to-the-minute information that will have a direct
impact on how your lab can avoid potential problems that could
result in significant reimbursement delays.
Flexibility
is key to any successful transition to form 5010. Your lab needs
to know in advance which payers are ready for the new forms and
which ones aren’t. So if your lab hasn’t done significant
testing with its payers, this audio conference is your chance
to find out what’s working—and what isn’t—with
many of the payers. You’ll learn about some of the biggest
problems and how to make sure they’re fixed before you submit
additional claims to those payers.
But
some payers simply won’t be ready. So bottom line: Be prepared
to send native 5010 and 4010 forms and decide which one to send
on a payer-by-payer basis. And make sure you can revert to 4010
at a moment’s notice to ensure timely reimbursement.
Whether
you work in a hospital, health system, or independent clinical
laboratory—even if you use your hospital’s billing
and collections department or an outside billing company—this
is one session you can’t afford to miss.
Register
today to get the latest on the new 5010 form, the changes you’ll
need to make, the problems you can expect, and how it could all
impact your revenue cycle management after the cutover. And remember
that your entire management team can learn and participate when
you register.
THE
DARK REPORT AUDIO CONFERENCE AT A GLANCE
COST: $245 per digital recording and materials
TO ORDER NOW:Click
here or call 1-800-560-6363 toll-free
The
best and worst news for labs about the first 18 days of form
5010 implementation.
Common
issues that prevent payers from prompt settlement of lab-test
claims submitted on 5010 forms, plus what labs can do to rectify
these problems.
Which
payers are struggling the most with 5010 lab-test claims, plus
the names of payers doing a great job processing 5010 claims.
Specific
steps your clinical laboratory can and should do to address
payer problems with form 5010 that will speed payment of conforming
lab test claims.
What's
working (and what isn't) in form 5010 implementation.
Simple steps to optimize your lab's ability to submit clean
claims and get timely/accurate payments.
…and
much more!
How
to ORDER AUDIO:
1. Online
2. Call toll free: 800-560-6363.
Your
audio conference registration includes:
Downloadable
PowerPoint presentations from our speakers
A
full transcript emailed to you soon after the conference
ORDER
Now!Or for more
information, call us toll-free at 800-560-6363.
Distinguished
Presenters:
Lâle
White is Executive Chairman and CEO at XIFIN,
Inc. She is a nationally recognized expert in the field
of medical financial management and regulatory compliance,
with more than 25 years of experience in information
systems development and medical billing. She lectures
extensively on these topics and has consulted for major
laboratories and laboratory associations throughout
the U.S. Ms. White worked with HCFA and the U.S. Office
of the Inspector General to develop the first OIG Model
Compliance Program. She was previously Vice President
of Finance for Laboratory Corporation of America and
its predecessor National Health Laboratories, where
she led the software development of several accounts
receivable, inventory, cost accounting, and financial
management systems for the laboratory industry. Ms.
White has a BA in finance and an MBA from Florida International
University.
Jackie
Griffin is Client Services Director for the
training and implementation teams at Gateway EDI. The
implementation team focuses on the overall direction,
implementation control, and completion of specific projects
ensuring consistency with company strategic objectives.
Ms. Griffin worked on Gateway EDI’s own 5010 transition
strategy, planning, and rollout. She also led efforts
to educate customers and the industry about 5010 planning,
issues, and concerns. Ms. Griffin began working at Gateway
EDI in 1999 to help with Y2K planning. She has served
in several customer-service positions, including supervisor
for executive accounts. She is an active member of the
Workgroup for Electronic Data Interchange and participates
in other industry groups such as the American Medical
Association, American Standards Committee, and Medical
Group Management Association. Ms. Griffin was a feature
speaker for the Workgroup for Electronic Data Interchange
5010 Forum and the GetReady5010 webinar series, presenting
on topics such as HIPAA 5010 Testing for Small Practices
and Planning for the “what ifs” of 5010.
Prior to joining Gateway EDI, she attended Missouri
College and worked in several provider offices gaining
an understanding of front- and back-office functions.
Matt
Warner is Associate Vice President, Operations
at XIFIN where he oversees the IT and EDI Services departments.
Mr. Warner works with all aspects of electronic data
interchange (EDI) with thousands of payers and dozens
of direct-trading partners, from enrollment to eligibility
and claims payment for each of XIFIN's customers. As
head of the IT department, he supports an SAS-70 audited,
high-traffic, Internet-facing, business-critical environment.
Previously, Mr. Warner was a Senior Systems Engineer/Infrastructure
Engineer at Intuit, and also held positions at MedImpact
and Caventa. He has a B.S. in mechanical engineering
from Brigham Young University.
ACCENT®
Continuing Education Credit
The American Association of Clinical Chemistry (AACC) designates
this program for a maximum of 1.5 ACCENT® credit hours towards
the AACC Clinical Chemist’s Recognition Award. AACC is an
approved provider of continuing education for clinical laboratory
scientists in the states of California, Florida, Louisiana, Montana,
Nevada, North Dakota, Rhode Island, and West Virginia.
Matt Warner