Pawtucket, R.I. — Jan. 19, 2012 — Priority Management Group, Inc. (PMG), a leading provider of revenue cycle management, billing and consulting services to community health centers (CHCs), announced today that several clients have already received payments for claims submitted in the new 5010 format. Payments have come from FQHC Medicare (NGS and MACs), state Medicaid programs across more than fifteen states, and scores of third-party commercial payers.
Pawtucket, R.I. — Jan. 19, 2012 — Priority Management Group, Inc. (PMG), a leading provider of revenue cycle management, billing and consulting services to community health centers (CHCs), announced today that several clients have already received payments for claims submitted in the new 5010 format. Payments have come from FQHC Medicare (NGS and MACs), state Medicaid programs across more than fifteen states, and scores of third-party commercial payers.
Regulations governing the information submitted on claim forms changed on Jan. 1, 2012. PMG staff were preparing for this change (the first major change in relation to claims submission in years) for the past eight months. Staff documented the required changes, worked with numerous partners (e.g. claims clearinghouses, system vendors, payers) to ensure communication and requirements were understood. They also conducted extensive testing to prevent cash-flow interruptions for CHC clients. Complicating the transition was an extension from the Centers for Medicare and Medicaid Services (CMS) eliminating penalties for some partners and providers until April 1, 2012. While PMG is confident in its historic and current work product resulting in unmitigated cash-flow for clients, PMG will monitor the process well past the newest deadline.
“Our staff worked tirelessly to ensure compliance ahead of the deadline” said Robert Skeffington, co-founder and executive vice president of PMG. “In this time of tight budgets for CHCs, every encounter needs to be submitted and paid quickly and correctly. Delays would be unacceptable to us and our clients. I’m happy to report that the extensive planning and testing were successful and that we expect no cash-flow issues.”
The 5010 transition is widely considered a precursor to another significant change occurring next year: ICD-10. Both transitions involve similar concerns, including possible cash-flow interruptions for those not sufficiently prepared. Administrators at the CMS have been instructing the healthcare community to begin planning now for what will be the most significant change to health care billing and reimbursement in over 30 years. PMG is well into the process of assisting its CHC clients with the ICD-10 transition.
About Priority Management Group
PMG is an industry-leading third-party medical billing company offering services to CHCs and look-alike organizations since 2000. We speak the CHC language and have dramatically increased revenues at each of our CHC clients. For more information on PMG or its expertise in 5010 and ICD-10 transitions, please visit www.gopmg.com or call Robert Skeffington (401-616-2020).