Medicare Compliance & Reimbursement - 2011 Issue 34
Part B Updates: Vendor Won't Be Ready for 5010? Get Claims in Before 2011 Ends, CMS Advises
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Article Overview
This premium update explains CMS guidance discussed during an Open Door Forum on two operational compliance topics affecting physician practices: the 5010 claims conversion transition and e-prescribing hardship exemptions. It is aimed at providers, practice managers, billing staff, and compliance professionals who need a broad understanding of CMS reminders, timing concerns, and where to seek help with payer, vendor, or exemption questions. The article covers CMS comments on mitigating claims-processing disruption, options practices were advised to consider, and general clarification of how e-prescribing exemption questions were being handled.
Why This Topic Matters
The article matters because it addresses Medicare Part B workflow and cash-flow continuity during a system transition period, while also highlighting a CMS deadline-related exemption process that could affect eligibility for e-prescribing penalties.
Article Sections
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5010 Transition Guidance
CMS guidance from an Open Door Forum on managing the claims submission transition period and coordinating with vendors, clearinghouses, and payers. The section focuses on broad operational concerns for practices facing conversion readiness issues.
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E-Prescribing Hardship Exemptions
Questions and answers about the e-prescribing exemption process and related timing concerns for eligible professionals. The section addresses general scenarios raised by callers and CMS responses on how exemption requests were handled.
What You Will Learn
- What CMS advised practices to consider during the 5010 transition period
- What types of e-prescribing exemption questions were raised during the forum
- Who was expected to handle exemption requests and related compliance steps
- What resources CMS pointed providers toward for follow-up questions
Who Should Read This
- Physician practices
- Practice managers
- Billing staff
- Compliance professionals
- Medical coders
- Revenue cycle teams
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