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Billing to multiple Medi-Cal FI's in 5010 Format
12/21/2011
There is a new national standard for electronic billing (EDI) files, called the 5010 format. The law states that by 2012 all healthcare transactions must be in this new format. The LTC Tools electronic file is subject to this regulation and is 5010 compliant.
The problem is that not all Medi-Cal FI's are ready to work with 5010 files. For example, the main Medi-Cal contractor, ACS, currently does not accept 5010 files. We have been instructed to continue billing in the old 4010 format for the time being.
However, other FI's, including Partnership Health Plan and Cal Optima are now requiring 5010 files. The fact that different FI's now require different file types mean that we had to make some changes to the program.
On the Electronic Submission page you can now decide which file format you would like to send. Most likely you will be submitting the old 4010 file to ACS. However you now have the option to submit to both test and production 5010 files to multiple Medi-Cal FIs.
The new Electronic Submission page should be relatively self explanatory. If you wish to add a new FI to your list, you can add it in Reference Files -> Facility.
If you have any questions you can always call or email us.
Thank you,
Your friends at LTC Tools.
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