Corporate Compliance

HIPAA 5010 logjam means no pay for physicians

Compliance Monitor, February 15, 2012

A strange thing is happening as physician practices transition toward HIPAA version 5010 electronic transactions, according to a February 9 HealthLeaders Media article.

Docs aren't getting paid.

Physicians are flooding their advocacy groups with complaints and questions about "cash flow problems." One physician broke down in tears about his inability to pay his staff.

"We haven't seen anything like this before," Robert Tennant, MA, senior policy advisory at Medical Group Management Association (MGMA) in Englewood, CO, told HealthLeaders Media in reference to the e-mails from distraught doctors.

The problems have intensified over the past month. Since the mandated transition to HIPAA Version 5010 began Jan. 1, data disruptions, unforeseen rejections of claims, and improper mailings because of address issues have stopped docs from getting paid.

Beyond that, communication snafus with clearinghouses and secondary payers have been a problem. The bottom line: These issues and more are resulting in payments not making it to physician offices, according to MGMA.

Read more on the HealthLeaders Media website.

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