Prime Clinical Systems, Inc.

3675 E. Huntington Drive

Pasadena, CA 91107

September 27, 2011

Dear Client,

As the deadline for ANSI 5010 draws nearer, Prime Clinical Systems anticipates an increase in references regarding the update and questions on the new requirements. Already we are experiencing higher volumes than usual. To help alleviate long wait times, PCS has put together a list of the most commonly asked 5010 questions and answers, which are available in this email.  

In addition, we have assigned someone to answer questions regarding the 5010 update process and data requirements. If, after reading the following FAQs and the information provided in the email sent 9/26/2011, your question is not answered, please do not call to open a reference or send an email to the usual email address. Instead, please direct all questions regarding ANSI 5010 directly to ANSI5010@primeclinical.com. Your question(s) will be answered as promptly as possible in a reply email.

If you haven't already signed up for the User Meeting being held in October, you may want to reconsider doing so. PCS will be covering each of the new requirements for ANSI 5010. For more information on the User Meeting please email:  marty@primeclinical.com.

• Is the 5010 UPDATE included in our Software Maintenance or do we have to pay for the update?
  Answer: If you have Support Maintenance, the 5010 Update is included.  

• Do we have to test for 5010?
  Answer: No. Prime Clinical is doing the testing for you.  

• When can we start sending 5010 claims?
  Answer: You can start sending 5010 claims after you receive the update.
  (Intellect) Any version > 9.12.18 is 5010 compliant.
  (UNIX) Any version > 8.2 (released 09/25/2009) is 5010 Complaint.

• Will the 5010 affect my HCFA 1500 forms or UB forms? If so, how?
  Answer: At this time, the 5010 will NOT affect HCFA 1500 forms or UB forms. However, click here to review 1500 form requirements.

• Does the address in Box 33 need to be changed from a P.O. Box if we are billing by Provider?
  Answer: Yes; a P.O. Box is not acceptable any more.
  From Palmetto Website: 5010 does require a physical address for the billing provider's location. Claims received with a P.O. Box in place of a physical address will receive an error.

• Can I begin adding the 4-digit zip extensions to other parts of my program? Are these extensions being accepted?
  Answer: Yes & Yes.

• Do I also need to make the change for the VERSION number in the Utility/Insurance?
  Answer:  Intellect: No, only in the Utility/Insurance/Telecom Screen.
  OnSTAFF: Yes  

• Will PCS be loading the new ICD10 Codes?
  Answer: No.
  YOUR OFFICE WILL NEED TO PURCHASE THE ICD-10 DISK from the AMA IN 'A SHORT TEXT FORMAT'.
  Intellect: has the capability for your office to import the ICD-10 codes.
  UNIX: This version of your program DOES NOT HAVE the capability for you as a user to load the ICD10 codes, however, if your office purchases the codes in 'A SHORT TEXT FORMAT', PCS will invoice your office the cost for loading the ICD10 codes.

• What should we being doing now for the new ICD10?
  Answer: No action is required at this time.
  January 1, 2013 is the date you need to start using ICD-10.  

• Can we start using the ICD10 Codes?
  Answer: No  

• Can we still bill in 4010 format, and when is the cutoff for 5010?
  Answer: Starting January 1, 2012 or before YOU MUST START USING ANSI 5010.  

• When we switch to 5010 billing, will we still be able to receive the ERA files automatically and are there any changes to the ERA files?
  Answer: Prime has made the necessary changes to accommodate for ERA and Eligibility.  

• Can I print the 277CA instead of just viewing it and can this be automated to print instead?
  Answer: INTELLECT: No; OnSTAFF: Yes

We appreciate your business and will continue to work with you as we go through the 5010 transition.

Prime Clinical Systems, Inc.

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