Lessons learned in 5010 Readiness

We have been finalizing our 5010 conversion these past couple of months and are coming to grips with the ramifications of what we can expect from our payers. Currently the Cvikota Company has a mix of direct relationships with payers and clearinghouse arrangements with our smaller volume payers. We’ve heavily relied on HBMA’s (www.hbma.org) 5010 readiness resources and education. Obviously that is invaluable. However it has been the attention to detail necessary with our payers to truly make sure that all of our I’s are dotted and our t’s are crossed.

Our latest challenge is making sure that the acceptance data that is returned from the payers is consistent for our internal tracking applications. Not surprisingly, we find ourselves with work to do to meld everything into a seamless format that our staff can utilize without having to worry about the differences that exist between payers. And that, my friends, is where all of this fails. The expense and effort to not only deliver, but manage yet another not-so-uniform standard in negating the efficiencies and cost savings that we all need to achieve. Even so, I am hopeful that the wider acceptance of these formats will lead to savings and efficiencies. The question is, will we survive to see the day? What tactics will succeed in the next two years?