MARCH NEWSLETTER

Here at Stephens & Associates we are in the midst of testing Validator version 5.8.0 (our official release). This version will have several additional features and improvements over 5.7.6, such as:

• Improved Demo Version allows you to use the program for 60 days with any carrier
• Rename and or zip your claim file and place it in any directory
• Added VNote.exe a S&A special note pad replacement which allows you to view reports, automatically translate 997 files, etc.
• Added ability for files downloaded from carriers to keep their existing names.
• Made changes to allow Validator to work with Lytec 2005's ERA feature.
• Multiple improvements to the AltaPoint version.

Fun with CMS!

Melissa Ethridge said, “The only thing that stays the same is change”. We believe that perhaps Melissa worked for the Centers for Medicare and Medicaid Services at one point in time.

Medicare has changed the way in which they accept claims both electronically and on paper. Stephens & Associates has been flooded with calls from clients who are getting claims rejected based on missing but required information in box 11 on the HCFA form (Insured Group Number).

After investigating each of these claims, it turns out that the clients in question, while they use the Validator to send claims, had ONLY their paper claims to Medicare rejected, not their electronic claims.

Stephens & Associates has investigated this issue thoroughly with Medicare, and Medicare has assured us that the electronic format has NOT changed at all, and that the recent change in requirements for box 11 applies to paper claims only.You can verify how the claims were received (at least by NHIC) by looking at the “ICN” number. If the first 2 digits are 11, 18, or 19, the claim was received electronically. If any other numbers are used, the claim was received on paper.

In the upcoming months, you will also start to see more rejections from all Medicare carriers if the Patient Name does not exactly match what is printed on the insurance card (i.e. “William” is not the same as “Bill”). Special Thanks to Sherry Moss for the heads up on this.

No Rest for the Wicked!

Stephens & Associates has been burning the midnight oil to bring you all of the improvements to the Validator 5 in version 5.8.0 (you may remember that all updates are free!). Well, in addition to working on making your existing Validator better, we have also started to take suggestions for the next major release of the Validator. Please be a part of the process and let us know what YOU think. Please e-mail your suggestions to Adam@SAtechs.com and put the term “Validator 6 Suggestions” in the subject line.