Effective August 1, 2012, the Medicare Fee-For-Service (FFS) program will only create the electronic remittance advice transactions in the X12 Version 5010 format. If the computer software used to open/translate the electronic remittance advice X12 Version 5010 format has not been updated to support the X12 Version 5010 format remittance advice, it may not be able to be opened and read to review payments, adjustments, and denials, as well as post payments to patient accounts.
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The leading reason for switching systems, cited by 44% of practices, is product issues. Service issues 15% and group consolidation 14%- such as when a hospital converts newly hired physicians to a new EHR. Other reasons include unmet expectations, concerns about the ability of the product to qualify for federal "meaningful use" bonuses, and a desire to have a single vendor for all practice software, including that for billing and scheduling.
Physicians received the wrong payment for nearly 1 of every 10 claims and there was a 69% increase in denied claims last year. The AMA estimates that mistakes, such as wrong deductible amount or treatment code, cost the system $7 billion.
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