[MT-L] BAR 5010 Claim Errors

[Gary Ring]

Is anyone having as many problems as I am with MEDITCH's new 5010 programs?  In addition to many other problems, they are generating Subscriber Address, City/State/Zip, and Demographic segments when the Subscriber is not the patient.  In 4010 these segments were suppressed and only the Patient Address, City/State/Zip, and Demographic segments were created.  During testing I am getting HIPAA-level errors from Claredi indicating that these "segments were not expected because the Subscriber Relationship (SBR-02) is not 18-Self".

 

In know in several other instances, MEDITECH has stated that their interpretation of the specs is that providing more info than necessary should not cause a claim to reject at the payer.  And in general, I agree.  But since these are considered HIPAA-level errors by Claredi, I can't be sure that MEDITECH's interpretation is correct.

 

Has anyone had this same problem when testing with payers, and have payers accepted your claims?  Or have they denied your test claims because of HIPAA compliant errors?

 

Any feedback would be appreciated.  Thanks.

 

Gary J. Ring
President

Ring Consulting, Inc.
978-807-1573
www.ringconsultinginc.com
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[Cheryle Giamartino]

I am receiving the same subscriber errors (from Claredi) and I have submitted a Meditech task for them to look at it.

Cheryle Giamartino, CPC
Business Systems Analyst II - Revenue Cycle/Meditech 6.0
Oswego Health
110 W Sixth St. Oswego, NY 13126
Office: 315-349-5659
cmgiam...@oswegohealth.org

Gary J. Ring
President

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[Cindy Olson]

Gary,
What is the loop? I'm having issues with Loop 2000C when the policy holder is different from the patient. I started a task and MT is reviewing. The Errata updated was loaded a couple of days ago that fixed one of our other issues.

Cindy

Cindy Olson
Billing System Coordinator
West River Health Services
Phone: 701-567-6153
Email: cin...@wrhs.com

-----Original Message-----
From: meditech-...@mtusers.com [mailto:meditech-...@mtusers.com] On Behalf Of Gary Ring
Sent: Thursday, September 22, 2011 12:28 PM
To: medit...@mtusers.com
Subject: [MT-L] BAR 5010 Claim Errors

Is anyone having as many problems as I am with MEDITCH's new 5010 programs? In addition to many other problems, they are generating Subscriber Address, City/State/Zip, and Demographic segments when the Subscriber is not the patient. In 4010 these segments were suppressed and only the Patient Address, City/State/Zip, and Demographic segments were created. During testing I am getting HIPAA-level errors from Claredi indicating thatthese "segments were not expected because the Subscriber Relationship (SBR-02) is not 18-Self".

[Gary Ring]

The redundant data is in segments 2010BA/N3, 2010BA/N4, and 2010BA/DMG.

 

Gary J. Ring
President

Ring Consulting, Inc.
978-807-1573
www.ringconsultinginc.com

----- Original Message -----

[Gura, Leslie]

I received the same errors below from Claredi below but our
Clearinghouse said to ignore. Medicare also said they will not edit for
excess information when we go live. 2010CA populated with the patien
information. Right now some of our Commercial payers actually will not
pay without this information when the Subscriber is not the Patient, so
I am a little nervous about how it will go when we are live.

All of our other errors resolved and our Clearinghouse is now testing
with payers.

Leslie

Subscriber Name (2010BA)
H45318:Subscriber Address was not expected because the Subscriber

Relationship (SBR-02) is not 18-Self

H45318:Subscriber City, State, ZIP Code was not expected because the

Subscriber Relationship (SBR-02) is not 18-Self

H45318:Subscriber Demographic Information was not expected because the

Subscriber Relationship (SBR-02) is not 18-Self

_____________________________________

Leslie A. Gura, MHA, CPA
Financial Consultant
UNC Health Care
211 Friday Center Dr., Suite 2001
Chapel Hill, NC 27517
919-843-3038 (p)
919-966-0086 (f)
919-810-0664 (c)

lg...@unch.unc.edu

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