2/12 HCFA Claim Form Requirement Deadlines

After April 1, there is no turning back. Following a three-month grace period, the new CMS-1500 HCFA 02/12 form launches this spring. Are your payers, your vendors, and your practice ready?

This year chiropractors and their staff will have to attend to the task of revamping their billing processes to accommodate the new HCFA 1500 version 02/12 claim form standards. The ubiquitous HCFA claim form is used by payers, providers, standards developers, data content committees, public health organizations, and vendors alike within the industry to report and process government health care claims. Developed and maintained by the National Uniform Claim Committee (NUCC), the form has undergone a significant makeover in order to align it with changes to the 5010 837P ANSI health care claim standard format, and also to support the ICD-10 transition that is due to occur in October of this year.  New changes to the form include an increase in usability, including additions and adjustments to fields that allow providers to use longer codes, enter more codes, and make further alterations to the information reported on these claim forms.

Work on the new HCFA version form began all the way back in 2009, with care being taken not to alter the existing look of the form or the underlying layout. The final draft was completed in 2011, and then approved in February of 2012. The draft was then submitted to CMS for approval and after a round of public comment, it was officially approved in June 2013.

Official launch of the new form began in January 2014, with payers receiving and processing paper claims submitted on this revised 02/12 version. In order to allow payers and providers to get up to speed and prepare themselves to perform under new requirements, a 2-month grace period for optional use of the form was put into effect from January 6 through March 31. During this time, dual submission of both version 08/05 and 02/12 has been allowed. But from April 1 forward, all rebilling of claims should use the revised CMS-1500 Claim Form (version 02/12) even if earlier submissions were sent on the prior 08/05 version. This is a critical note for providers: Medicare will only accept claims that are submitted on the new 02/12 version of this HCFA form.

Providers should work closely with their EHR vendors and clearinghouses to ensure that their software and their payers are prepared for the adjustment and the April 1 deadline. They'll also have to train their staff and familiarize themselves with how the adjustments affect their current billing practices. To prepare for this impending transition, providers should begin talking with their EHR vendors and inquiring about their readiness to ensure that vendors have allotted ample time to upgrade their users to a compliant system. Many payers have added grace periods extending past the April 1 deadline to help ease the burden on their providers.

To put our providers in position for this adjustment, necessary changes have been made to the ChiroTouch software to accommodate these new HCFA 02/12 claim form adjustments. We have also reached out to many of the major payers to inquire about grace periods to assure our clients that we have a comprehensive understanding of how this transition will affect their current operations. Contact ChiroTouch to learn more about how we can keep your practice running with a comprehensive approach to billing, compliance, and industry standards.

To prepare for the transition, we suggest all providers who print CMS 1500 or submit print image claims electronically speak with their EHR vendors, and those who print their claims use up any remaining stock of 08/05 forms and order the new 02/12 version for their upcoming claim submissions. If you need additional information, we also suggest reviewing materials under the 1500 Claim Form tab at the NUCC Website: www.nucc.org.

 

This information was brought to you by Integrated Practice Solutions, makers of ChiroTouch. www.ChiroTouch.com.