5010 Compliance

Product Details

We are pleased to report that in 2011 Pulse successfully completed developing the enhancements to enable your medical organization to process claims in compliance with the new mandatory 5010 standards. In addition, we successfully completed our testing with all major clearinghouses and those direct connect payers that are ready.

While our efforts represent a significant accomplishment there is more work to be done. Most of our Pulse users have made a smooth transition to filing claims under the 5010 rules. However, these mandated rules have caused significant system changes with all stakeholders’ Health Information Systems including payers and clearinghouses, causing issues with claim rejections, reports and payments delays. Many payers were not ready in advance of the deadline and work remains.

As a result, we are currently experiencing a heavier than normal call volume on the Pulse Help Desk, causing longer than expected wait time and response delays to our clients. Our Help Desk is also being challenged by significant delays in getting answers from the various clearinghouses. Payer and clearinghouse responsiveness is now extended to several days.