In order to comply with the April 1, 2014 deadline for the change to the new CMS 1500 02/12 claim form, many Medisoft and Lytec users are getting notices from their clearinghouses explaining that they will no longer be accepting print image files and that users must begin submitting claims in the ANSI 5010 format.
Here is a sample of what you may see when you are sending claims that notifies you that you are sending a “print image” text file.
If you are sending claims using a print image format you are essentially printing the old claim form to a text file and sending that “print image” to your clearinghouse who is then converting the information from the print image into the ANSI 5010 format for you. Since there are significant changes to the claim form and the data captured on the new form (new qualifier codes and fields that have been converted to include data that was not reported on paper before) it may not be feasible any longer for clearinghouses to convert the file for you and many clearinghouses are now requiring that users send their claims already in the ANSI 5010 format.
The good news is Medisoft v19 and Lytec 2014 are both equipped with, not only the new 02/12 claim forms, but also with Revenue Management which can be configured to send claims to any clearinghouse or even directly to the payers in the 5010 format. In addition Revenue Management has features such as claim scrubbing and ERA posting that your practice can take advantage of as well.
While the Revenue Management application is included with Medisoft v19 and Lytec 2014, it does require setup and configuration to successfully utilize it. If you need to get setup on Revenue Management please call us at 888-988-7796 to schedule configuration and training with an EDI Professional!
We highly recommend contacting your clearinghouse directly to discuss this change and to coordinate the switch from the print image file to the ANSI 5010 format.
As a final note, If your clearinghouse indicates that they will continue to accept print image files please verify with them whether or not the print image file has to be producing the fields and data captured in the new CMS 1500 02/12 claim format, or if they will still accept the 08/05 claim format. If they are requiring the 02/12 format then you will still need to get setup on Revenue Management as CMS11.exe is not programmed to produce the new claim form.