EDI 5010 Frequently Asked Questions

EDI 5010 Frequently Asked Questions

EDI 5010 Frequently Asked Questions 2 EDI 5010 Frequently Asked Questions 1. Which versions of 5010 do MultiPlan and Viant support? 2. If we don t upgrade to 5010 will MultiPlan and Viant be able to support our files? 3. Where are the 5010 changes outlined? 4. When do you plan to start testing? 5. What if we use a proprietary 4010 837 format? 6. Do MultiPlan and Viant maintain separate test and production environments and are they secure? 7. What is the testing process? 8. What is the average turnaround time for test files? 9. How long is the implementation process? 10. Will MultiPlan and Viant support the new 999 Implementation Acknowledgement and 277CA Claim Acknowledgement transactions supported by CMS? 11. What is the impact for clients using the Internet-based version of MultiPlan EnterPrice (Remote) or Viant WebPricer? 12. How do I contact MultiPlan and Viant to set up testing?

EDI 5010 Frequently Asked Questions 3 1. Which versions of 5010 do MultiPlan and Viant support? As you know CMS currently supports the ASC X12 4010 version for EDI transactions. These include professional and institutional claims supported in the EDI format. HIPAA 5010 is the new ASC X12 EDI version introduced by CMS. MultiPlan and Viant will support the 005010X222A1 and 005010X223A2 versions. 2. If we don t upgrade to 5010 will MultiPlan and Viant be able to support our files? Yes, MultiPlan and Viant will continue to support the 4010 X12 format. However, clients will need to transition to 5010 to meet ICD-10 requirements that go into effect in October 2013. 3. Where are the 5010 changes outlined? MultiPlan and Viant created 5010 837 Companion Guides, and these guides outline the differences between the 4010 version and detail new features supported by 5010. PDF versions of the guides are available on our HIPAA 5010 websites: MultiPlan Companion Guide: http://www.multiplan.com/hipaa_5010_multiplan/ Viant Companion Guide: http://www.multiplan.com/hipaa_5010_viant/ Additionally MultiPlan created an Information Bulletin for clients using the REFIG and K3 segments: Adobe Acrobat Document 4. When do you plan to start testing? MultiPlan and Viant completed the gap analysis and internal development and are ready to test with clients now. 5. What if we use a proprietary 4010 837 format? If you plan to make changes to your proprietary format as a result of 5010, MultiPlan and Viant require ninety-day advance notice to make the changes at our end so we can start testing the 5010 proprietary file exchange. 6. Do MultiPlan and Viant maintain separate test and production environments and are they secure? Yes, Multiplan and Viant have separate test and production environments for client

EDI 5010 Frequently Asked Questions 4 implementations. Virtually all of our EDI clients transmit their files to MultiPlan and Viant via encrypted file transfer protocol (FTP). The FTP test and production setup will be discussed during the initial conference call, and connectivity will be established within the first couple of weeks of the implementation process. 7. What is the testing process? MultiPlan and Viant are taking a multifaceted approach in terms of the 5010 transaction testing and will include direct testing as well as web-portal testing. Typically testing is an iterative process comprising two or three test cycles. MultiPlan and Viant test the structural integrity of client test files and conduct a volume test for each client. Additional details are outlined in the Test Strategy document at the following locations: MultiPlan Website: http://www.multiplan.com/hipaa_5010_multiplan/pdf/5010_edi_testing_approach.pdf Viant Website: http://www.multiplan.com/hipaa_5010_viant/pdf/5010_edi_testing_approach.pdf 8. What is the average turnaround time for test files? It generally takes MultiPlan and Viant approximately one week to review and process the initial test file. As subsequent test files are processed, and become progressively cleaner, the turnaround time decreases to approximately three business days. In terms of production timelines, MultiPlan requires about a week to set up clients in production. 9. How long is the implementation process? In our experience, implementation time frames vary greatly. Variables include the experience of your IT team and whether you need to employ an outside vendor. The most common cause of a long implementation tends to be the slow turnaround of test files. If prospective clients are unable to turn around test files in a timely manner and generate new test files, the implementation timetable can be greatly extended. The average time frame is 45-60 days from receipt of the initial test file. 10. Will MultiPlan and Viant support the new 999 Implementation Acknowledgement and 277CA Claim Acknowledgement transactions supported by CMS? MultiPlan and Viant will support the 999 transaction. MultiPlan supports the 277CA transactions for clients that utilize PHCS Savility, and Viant does not support 277CA transactions at this time.

EDI 5010 Frequently Asked Questions 5 11. What is the impact for clients using the Internet-based version of MultiPlan EnterPrice (Remote) or Viant WebPricer? There is no impact to MultiPlan clients using the Internet-based version of EnterPrice (Remote). To more fully support the 5010 claim transaction, Viant has enhanced the WebPricer application to allow for the optional entry of the national provider identifier (NPI). 12. How do I contact MultiPlan and Viant to set up testing? If you have questions or would like to schedule testing, please send an email to the 5010 inbox at 5010.implementation@multiplan.com. To accurately plan the allocation of our resources, we require ninety-day advance notice from clients for 5010 testing.