Thursday, July 26, 2012

Medicare to Automatically Convert Format 4010A1 Electronic Remittance Advice (835) to X12 Version 5010 Effective August 1, 2012

Effective August 1, 2012, if you have not yet converted from the 4010A1 format of the electronic remittance advice, the Medicare Fee-For-Service (FFS) program will automatically convert your electronic remittance advice to the X12 Version 5010 format. If the computer software you use to open/translate the electronic remittance advice X12 Version 5010 format is not ready for this conversion, you may not be able to open and read the electronic remittance advice to review payments, adjustments, and denials, as well as post payments to patient accounts. If you use a vendor, clearinghouse, or billing service for receipt of your electronic remittance advice and your computer software is unable to open/translate the electronic remittance advice X12 Version 5010 format, please contact your vendor, clearinghouse, or billing service before contacting your Medicare contractor.

Providers should be advised that any billing staff or representatives that make inquiries related to Medicare payment on his/her behalf will need a copy of the remittance advice. Any issue with opening/translating the electronic remittance advice X12 Version 5010 format effective August 1, 2012 should be addressed with your vendor, clearinghouse, or billing service, if you use one of these entities for receipt of the electronic remittance advice, before contacting your Medicare contractor.