NOTE:  If you have read this article AND the step by step instructions at www.geniussolutions.com/5010 and still have questions about 5010, please call me at 586-365-4712.  Please call Support for questions regarding AutoUpdating or other non-5010 related issues.





Today, December 20, 2011, Genius had a conference call with BCBSM EDI and we have this information to share:

Genius has agreed to continue to move clients to the new 5010 format as soon as possible.

As of 12/20/2011 BCBSM is only accepting Blue Shield, FEP, and Blue Cross Medicare Advantage (payor 00710) in the new 5010 format. You can continue to send all claims in 4010 as of right now.

At this time BCBSM expects to accept Commercial, Medicare, and BCN "before the end of this year". They expect to accept DMEnsion (MADME) and Medicaid claims on 1/1/2012. Genius expects to email update announcements to our clients as BCBSM announces when they will accept which lines of business.

Because not all Genius clients have moved to 5010 and BCBSM is not able to accept all lines of business today, we have asked BCBSM for an extension of the 1/1/2012 5010 deadline on our client's behalf.

Even though CMS has announced a 90 day delay in enforcement of the 1/1/2012 5010 requirement, BCBSM states that for clients that can not switch to 5010 on time, BCBSM can only accept 5010 and 4010 through 1/30/2012.  January 31 and on must be only 5010 format for all lines of business.

Technically this will probably mean everything but Medicaid could still be billed in the old format through 1/30/2012, but we are hoping you will switch completely to 5010 well before the end of January.

Medicaid is currently telling BCBSM that claims received after 3:00 p.m. 12/28/2011 must be in 5010 format. This is because claims sent after that and before 1/3/2012 will be held and processed on 1/3/2012 and will therefore need to be in 5010. Genius is not certain this mandate will stand, so we recommend Medicaid electronic claim submitters make certain all Medicaid claims are sent in the old format BEFORE 12/28/2011 to avoid switch-over issues. Medicaid submitters should look for an announcement from Genius in early January as to the actual status of Medicaid taking or requiring 5010 or 4010 for 2012.



In light of these announcements Genius is recommending this course of action for our clients:

Visit www.geniussolutions.com/5010 and read the Michigan BCBSM 5010 THOMAS article and begin sending Blue Shield, FEP, and Medicare Advantage claims today.

Before December 28 bill out ALL Medicaid in the old format.

You might consider planning on not billing anything 12/28/2011 through the first week of 2012 to allow BCBSM to work out any early issues. Please check with your boss before holding claims.  If you feel strongly that you must bill 5010 without delay, give me a call.

Look for an email announcement from Genius in early January that we have verified what BCBSM is actually accepting, and if it is working properly. We hope to announce all lines of business are ok for 5010 at that time, but we want to test with a few clients to make certain.

We plan to have a First Friday of the Month Conference Call on January 6th at 10am to discuss the latest happenings.  Look for an email invite to the conference call a few days before 1/6/2012.

Make certain you have everything being sent in 5010 by January 23, 2012, unless we notify you there are still issues preventing it.