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Q27331 - HOWTO: Activating the ANSI 5010 Claim Format

To help you prepare to meet the new 5010 requirement, we have created the HIPAA 5010 Compliance Center. After you answer a few short questions, the HIPAA 5010 Compliance Center provides you with a customized plan for meeting the new 5010 requirements with OfficeMate v10.5.23 and above. Visit the HIPAA 5010 Compliance Center today.

If the HIPAA 5010 Compliance Center instructs your office to download and install the latest version of OfficeMate, go to MyInstallCenter.

Note: If you are using OfficeMate 12.0 and above, the ANSI 5010 claim format is automatically activated in your software.

If your office has downloaded and installed OfficeMate 10.5.23 - 11.2:

Important: For each location in your practice, including the administrative location, enter the full nine-digit ZIP codes and replace any post office boxes with a physical address.

Important: Verify that your clearinghouses are ready to receive claims in the ANSI 5010 format before proceeding.

  1. Ensure that OfficeMate, ExamWRITER, and OfficeMate Administration are closed on all other workstations.
  2. From the OfficeMate Administration main window, click Setup.
  3. Select Third Party Setup.
    The Third Party Setup window opens.
  4. Click the Options tab.
  5. Click Convert 4010 to 5010.
    A dialog box opens and warns you that OfficeMate Administration will be closed.
  6. Click OK to close OfficeMate Administration.
    OfficeMate Administration closes and the OfficeMate 4010 to 5010 Conversion window opens.
  7. Read the warnings, select the check box to acknowledge the warnings, and click Convert.
  8. Click Yes to convert your claims from the ANSI 4010 to the 5010 format.
  9. Once the conversion is complete, open OfficeMate or OfficeMate Administration.
    Electronic claims created in OfficeMate will be sent in the ANSI 5010 format.
    Note: To verify that you are sending the 5010 format, open the Third Party Processing window, click Maintenance and Options, and select a clearinghouse. The Version Code fields should display 5010A.
    Note: You must refresh all of your open claims to update them to the 5010 format.

Qualifier Changes
In addition to the format changes, the 5010 requirements also changed the requirements for some of the qualifiers used in insurance claims. If you had previously selected a qualifier that has been discontinued, your selection is now blank on the CMS 1500 form. The blank qualifiers will cause errors in the Third Party Processing window.

Since the Third Party Processing window explains the nature of the errors, you can correct them as they occur, or you can  proactively find and replace discontinued modifiers. Once the discontinued modifiers have been replaced, you may need to refresh the claims in the Third Party Processing window before processing.

For more information, refer to the "Setting Up Insurance Carriers & Plans" chapter of the OfficeMate Administration User's Guide, which can be found under the Help menu within the software.

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HIPAA 5010 Compliance Center
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Created on 10/27/2011.
Last Modified on 7/28/2015.
Last Modified by Customer Care.
Article has been viewed 5554 times.
Rated 7 out of 10 based on 4 votes.
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