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UHIN 2010 Spring Provider Fair |
| 05/12/2010 |
| News >> Community News |
UHIN Spring Provider Fairs Update the Community
Another set of educational workshops has come and gone. The bi-annual UHIN provider fairs highlight the hottest topics for providers, giving everyone a chance to learn, ask questions, and provide feedback on various issues. This spring, the big discussions included Electronic Data Interchange (EDI), the upcoming ICD-10 and 5010 transitions, the new clinical Health Information Exchange, and how to read payer reports. In addition, providers were able to interact in a question/answer session with a panel of payer representatives.
At the end of each provider fair, attendees had the opportunity to provide feedback and ask for additional information on their topics of greatest interest. Some of the same questions and subjects appeared over and over, suggesting that these in particular deserve to be revisited. So as a refresher for the people who attended the fairs and an introduction for those unable to come this time around, we created the below list of FAQ’s.
Top 3 Frequently Asked Questions:
1. Electronic eligibility- what is it? How does it work?
Electronic eligibility provides a tool to find out whether or not a patient has coverage. Called a 270/271 Eligibility Query, this type of transaction can be real-time (meaning the payer response arrives in less than a minute), or batch (the payer responds every hour or two hours with all their replies at once).
If you want to know more, please contact UHIN or your current clearinghouse/billing service. If you utilize UHIN’s UHINt 2.5 software, you can view a training video by clicking the following link http://www.uhin.org/pages/membership/education-training.php and selecting video #13 about eligibility.
2. ICD-10- what is it? What do I need to do to prepare?
ICD-10 is the new coding system for diagnosis and procedure codes. It will include more than twice the current number of codes, which will allow for much more precision. The nationwide switch from ICD-9 to ICD-10 should occur 01/01/2013.
To make sure you are prepared for ICD-10, contact your Practice Management Vendor. Ensure they are on track with any necessary software adjustments. Ask whether they plan on making a crosswalk between ICD-9 and ICD-10 in their system… or whether they will leave the new codes up to you. If you bill for your facility, it might be worth your while to start taking a class or training on the new ICD-10. Also look for an updated version of your coding handbook- new versions should list the ICD-10 codes.
3. 5010 transition- what is it? What do I need to do to prepare?
For years, electronic exchanges have been using version 4010. This is just a number to describe a format for the electronic files. In order to accommodate the new ICD-10 codes, everything will switch to version 5010. This switchover should occur 01/01/2012, one year before the move to ICD-10.
To be ready for 5010, contact your Practice Management Vendor and make sure they plan on upgrading their system, and that they will complete all required testing. Also ask about a payer-specific ability to toggle between 4010 and 5010; not all insurance companies will switch to 5010 at the same time, so you may have a period of time when you submit in 4010 for some and 5010 for others.
These FAQ’s are very general, so if you have more questions please contact whoever submits your electronic claims. This could be your billing service, clearinghouse, or UHIN. The UHIN provider fairs will return in the fall, so if you have suggestions on topics you would like to see, please send your suggestions to customerservice@uhin.org.
Save the following dates for UHIN’s 2010 Fall Provider Fairs!
Orem (Medical) - Friday, Sept. 24th
Ogden (Medical) - Friday, Oct. 8th
Salt Lake City (Medical) - Monday, Nov. 29th
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