BCBSM 5010 Update 1/26/2012 - Part 2 Medicare goes live


Today we received this message from BCBSM:  "We have removed the P900 edit for WPS and a broadcast message is going out tonight that we.re live with WPS"

Basically this means as of 3pm 1/26/2012 BCBSM says they should be able to receive your Medicare claims in the new 5010 format.  Early adopters may begin right now.

I also clarified the 1/31/2012 deadline.  BCBSM now says "WPS has granted us an extension through 3/31/2012 to accept 4010 and 5010.  However WPS reserves the right to change that date given 30 days notice."

What this means is BCBSM can't guarantee anything more than 30 days from now, but it could be April 1st before you are absolutely required to be 5010 with Medicare.

Mark's standard advice is if you are getting paid in 4010 on Medicare right now, wait a week or two before trying any in 5010 to let the dust settle down.  If you are fun spirited, go ahead and try a couple of Medicare claims in the new 5010 format right now and let me know how it goes.  But please call me directly at 586-365-4712 instead of Support.

So in summary, here are my suggestions:

If you are a new Medicare provider or recently changed your 855 Enrollment Form with Medicare and WPS has told you that you MUST send only 5010, then you should start right now.  This is only a handful of people.

Everyone else can still send all claims except Medicaid  in the old 4010 format, so hang tight and don't make changes for the next two or three weeks.  This will give us time to verify everyone is getting paid correctly and release updates if necessary.  Hopefully our call volume will decrease and it will be easier for you to move.  Maybe BCBSM will even take everything in 5010 by then.

When you do start sending 5010 be sure to send only a few claims and verify they are working properly before doing a whole lot.


BCBSM also states they will continue to return the 835 Payment reports in the old 4010 format until further notice.  This is fine, no need to worry until BCBSM says it is required to be 5010.  Hopefully that will be a while so people can get settled in billing in the new format.



PS.  Still no word on Commercial or DME/MADME in 5010 yet.