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Elizabeth M. Whitehorn, Director

Provider Notice issued 03/27/12

Discontinuation of Dual Processing

To:​ ​All Medical Assistance Providers
​Date: ​March 27, 2012
​Re: Discontinuation of Dual Processing​

The purpose of this notice is to inform providers that beginning May 1, 2012 and after, the department will only accept HIPAA 5010 transactions. HFS will no longer be accepting 4010 versions of any of the following ASC X12 transactions.

  • 837I – Health Care Claim (Institutional)

  • 837P – Health Care Claim (Professional)

  • 276/277 – Claim Status Request/Response

  • 270/271 – Eligibility Request/Response

The compliance date for the new format was January 1, 2012, but due to the announcement by the Centers for Medicare and Medicaid Services that no enforcement actions would be taken until June 30, 2012, HFS has extended a dual use period until April 30, 2012.

Providers need to contact their billing services and clearinghouses to make sure their transactions are being submitted to HFS in the correct format.

For current updates to the 5010 transactions, EDI transaction issues, FAQs and links to Companion Guides, please refer to the EDI Web Page. Please ensure that a copy of this notice is made available to either your software vendor or IT department.

Any questions regarding this notice may be directed to the provider's medical assistance consultant in the Bureau of Comprehensive Health Services at 1-877-782-5565.

 

Theresa A. Eagleson, Administrator

Division of Medical Programs