5010 Provider Bulletin: January 31, 2012
This is a special bulletin with important 5010 information.
An Important message from the UHIN Help Desk:
We appreciate your patience as we continue working through issues related to the transition to our new clearinghouse functionality and version 5010. Due to these significant changes, we have experienced an enormous increase in the volume of calls, voice messages and emails we are receiving. We are continuing to work through reported issues to ensure uninterrupted service.
If you are experiencing any issues, the following updates and suggestions may be helpful:
Claims:
837 Claim Errors (For claims transmitted after 01/01/2012)
Some claims to various payers referenced the error “the 1000B NM103 is blank”. We have fixed this issue and are working to resubmit the affected claims. If you see this error and have not received a new acknowledgement, you can resubmit your claims.
4010 vs. 5010 formatted claims to payers.
Which version should I be using to send my claims?
- Medicare claims- 4010 vs. 5010: UHIN submitters received a “Blanket Approval” for Medicare. This means that if you can send a Medicare 5010 claim file, you can start transmitting 5010 claims at any time to Medicare. Total OnBoarding shows pending approval status, but the Medicare system allows UHIN members to send either 4010 or 5010 version claims at this time.
- Utah Medicaid claims: 4010 vs. 5010: Utah Medicaid is currently accepting version 5010 Institutional claims, Dental claims, and Professional Encounters (to HT000004-002) only. Professional Fee for Service (HT000004-001) and Atypical (HT000004-801) claims must be transmitted in the 4010 format.
- For any other payer, please reference the January 17, 2012 bulletin. The Payer Readiness list gives the status for each payer.
If you are sending 5010 claims to a payer not currently accepting this version, please resend the claims in version 4010. If your software does not allow you to choose 4010 or 5010 by payer, please send version 4010 transactions at this time. Please watch for upcoming announcements.
UHINt shows an “UP” status but the payer does not have my 837 claims.
With the addition of the new UTRANSEND clearinghouse functionality, we now have a new meaning for the UP and Transmission Complete statuses in UHINt. In the past, these statuses meant that the transaction was in the payer's system, so if any data or reports were missing we would have advised you to call the payer. The new functionality means that the UP and Transmission Complete statuses indicate that the transaction was received by UHIN. If you have missing data or reports, please contact UHIN instead of the payer.
Reports:
Claim acknowledgements (277, 997 and 864)
If you are receiving 4010 reports, your acknowledgements will continue to appear in the UHINt tool. These 4010 version reports are not available in UTRANSEND.
If you are receiving 5010 reports, your acknowledgements will be available in UTRANSEND.
NOTE: Beginning January 11, 2012, Medicare experienced a delay in their ability to send reports. We are working with Medicare to resolve this issue and expect reports to be flowing effective February 2, 2012.
If you have not received a claim acknowledgement report within 24 hours please contact UHIN before retransmitting the claim.
Claim Payment or Remittance Advice (835)
Some payers are sending 835 (Electronic Remittance Advice) reports in the 5010 format. UHINt will still receive these reports but will NOT display them. These reports are viewable in our new UTRANSEND reporting tool. If you use third party software to display and/or auto-post your 835s and that software is compatible with version 5010, you may continue to use that software.
We continue to see improvement in the flow of reports. If you have checked both UHINt and UTRANSEND and are missing reports, now is the time to contact us (for contact information, see the Getting help section at the bottom of this page). It is important to include details, such as the payer name, check date, check number, check amount and your UHIN trading partner number.
Note: If a missing 835 report was sent prior to January 1,2012, you will need to contact the payer to have the report reposted.
How can I get my 835 (remittance) reports imported into Medicare Easy Print?
The UHINt software will still download the 5010 835 report and save it to your computer. Make sure you have updated Medicare Easy Print to version 3.2.2, and you can use it normally. To download the latest version of Easy Print, go to https://www.cms.gov/AccesstoDataApplication/02_MedicareRemitEasyPrint.asp. Please remember that Medicare Remit Easy Print was designed for Medicare reports, and sometimes data from other payers does not display correctly. As an alternative, you can view the report in UTRANSEND.
UTRANSEND
What is UTRANSEND, and do I have to use it?
If you use UHINt to view your reports, UTRANSEND will be the primary way for you to view 5010 reports. This new system will give you more information than ever before. You will be able to view any errors in your claim almost instantly after you transmit the claim file. UHIN is now doing front end edits, which will ensure your claims are clean and properly formatted.
You will no longer need to be in the office to access your reports. Since UTRANSEND is web based, all your information is securely stored with UHIN so that you can see your information anywhere, any time.
You can also run informational reports about your office billing. There are charts that can display your successful transactions, unsuccessful transactions, and totals.
How do I get training for UTRANSEND?
You can watch our short UTRANSEND Training Video. In addition, we offer in-person and webinar classes. To see a schedule of upcoming classes, visit UTRANSEND Training Opportunities.
How do I get a user ID and Password for UTRANSEND?
Please see the “Getting Help” section at the bottom of this bulletin.
What is the correct web address for UTRANSEND?
https://www.utransend.net. You can also access the UTRANSEND portal from a button labeled "UTRANSEND" in the upper-right corner of this website.
Can I use UTRANSEND to send my claim files?
Not at this time. Please continue to transmit claims using your established routine.
Can I export my reports from UTRANSEND?
UTRANSEND does not currently have an export function for reports. (Technical note: Most screens will display the raw data from the transaction. You can copy and paste this data into a document if you wish. This raw data requires a translator or practice management software to view.)
Will UTRANSEND track my 4010 transactions?
No, at this time UTRANSEND is designed to track 5010 information.
UHINt Software
Should I upgrade to UHINt 2.6?
Yes. The 2.6 version allows you to take advantage of UHIN’s new clearinghouse functionality, including front end edits, the 4010 to 5010 Step-Up service, and the UTRANSEND portal.
Software Vendor Note: We have heard that some software vendors are recommending that you stay on version 2.5, which is fine as a temporary measure. Several software vendors are working with UHIN to directly connect their software to the UHIN network.
UHINt 2.6 Environment Banner
The banner on the left-hand side is now bright yellow. The text box reads “Non-Predefined Environment”. This is normal and means that you are on the current UHINt 2.6 production environment.
Identifying a Payer
The payer name for 5010 reports will no longer display in UHINt. You can identify the payer by looking at the file name. A list of payer names and Trading Partner Numbers is available in Preferences > Payer Maintenance.
UHINt Real Time Responses
UHINt 2.6 does not receive real-time responses at this time. If you need to send a real time eligibility request, please change the environment to “UHINet II Production (Butch)” before you log in. You can change the environment using the Change Environment menu available in the lower-right corner of the welcome screen.
When will UHINt be replaced?
We are currently reviewing possible alternatives to the UHINt software. Watch future communications from UHIN for more information.
Getting Help
We are currently experiencing a large volume of phone calls and correspondence. Your calls and correspondence are important to us. Please continue to report problems to us so that we can provide the correct solution and get your claims and reports flowing.
PREFERRED: The following two options allow us to distribute your request promptly and respond after hours.
Web Support: http://www.uhin.org/pages/membership/help-support.php
Email: customerservice@uhin.org
If you send us an email, using the format suggested below will help us get your issue to the right people:
Subject Line Examples:
• Missing Reports
• Claims rejecting
• Claims not reaching payer
• UTRANSEND training and assistance
• UHINt software problem
• Problem with practice management using both 4010 and 5010
• UHINt password or log in issues
• UTRANSEND password or log in issues
Please include in the body of your email:
• Trading Partner Number (this is very important)
• Contact Name
• Contact Phone Number
• Description of problem
o If you are missing claim confirmation reports (277, 864 and 997/999), please include the date your claim transmitted and the payer(s) receiving the file(s).
o If you are missing claim remittance (835), please include the check date, check number, check amount and payer name from whom you received the payment.
Phone Support: 801-716-5901 (SLC Area) 877-693-3071 (Toll-Free)
IMPORTANT NOTE: Average wait time for phone support is currently 5-7 minutes. If you choose to leave a voicemail please be sure to include the following information.
• Contact Name
• Contact Phone Number
• UHIN Trading Partner Number
• The reason for your call, including any applicable dates and transaction types (for issues regarding claims, reports, errors etc.)
This information will allow us to do some basic research prior to returning your call.
