IMA Systems and Services | Announcing Release 14 Service Pack 3 (v14.3)

Announcing Release 14 Service Pack 3 (v14.3)

IMA has completed programming a new interface for HIPAA Transactions and has successfully tested it with Empire BCBS for Medicare billing submissions. As soon as Medicaid is ready, IMA will test this new interface with them as well. The new functionality for HIPAA Transactions will be included in version 14.3 of the IMA software and is scheduled for release in early July 2003.

Updating to v14.3 will require that your system has been already updated to v14.2. Therefore, every agency will need to plan to update their production systems to v14.2 by the end of June in preparation for the July release of v14.3. Your cooperation will be needed to successfully convert your system to this new version in time. The v14.3 updates and subsequent cutover to the new billing interface will have to be completed within a 10 week period at each of the more than 30 IMA installations.

In addition to having v14.3 installed, you will need to learn about the new HIPAA billing process, define and update a series of new billing related definition codes, and perform a successful test submission with each of your electronic payers. Collectively, these payers are now referred to as "Receivers" of electronic submissions.

The IMA billing process under HIPAA will be pretty much the same as before but will place an additional burden on the agency in the following two areas:

The agency system administrator will need to be involved much more than before in defining the various agency parameters.

The agency will have to assume responsibility for these parameters and follow up directly with the processing organization for the correction of reported billing errors related to these parameters.
In effect, each agency will need to assume responsibility for the contents of the submission file. They will have to be able to distinguish between the Agency parameters that they control themselves as compared to what is controlled by the IMA system.
These parameters will have to be set up and controlled by the agency for each "Receiver" utilizing the new setup screens along with a new set of M errors that will be made available in v14.3 for this purpose.

As part of the initial setup of these agency parameters for each "Receiver", it is advisable, and required by some "Receivers", to do a test submission. More than one such test may be needed to ensure that everything is setup right, before going live and risking actual cash flow.

In preparation for these requirements, IMA has outlined the following events that each agency needs to schedule and complete within this tight timeframe.

Update your test system to v14.3.

Reserve a seat and participate in one of the HIPAA cutover seminars to be given by IMA at IMA on July 1 and July 8.

Schedule time with IMA for remote support for setup and testing of a HIPAA billing submission for each of your designated HIPAA "Receivers" (e.g. Empire BC/BS for Medicare, CSC for Medicaid, etc.).

Update your production system to v14.3.

In order to get everyone ready prior to this deadline, we will need to establish a very tight schedule with each agency for the upgrade and the follow-up HIPAA cutover support. During this 12-week period IMA will be able to schedule only a maximum of 4 agency "Receiver" tests per week as described in (c) above. To be fair, the v14.3 updates and the follow-up HIPAA submission tests will be scheduled for customers on a first come, first served basis.

Participating in the HIPAA seminar and purchasing IMA's setup and testing services are highly recommended. Your participation in the seminar will equip you to address the many definition changes required for the new HIPAA Transactions. Your participation will also give your agency priority status in the v14.3 update schedule. Additionally, our HIPAA Transaction testing service will guarantee that the switchover is successfully accomplished.

Services & Prices

You also need to budget for a number of additional costs associated with the transition to the HIPAA transaction codes as listed below.

Item

Cost

v14.3 software and system updates to include HIPAA transaction codes

No charge

One day HIPAA Transactions seminar at IMA. This seminar will explain and review the requirements and procedures insetting up the new HIPAA transactions within your agency.

$500 per person

Setup and testing support of successful billing submission. This service will provide you with all the support needed for your testing per "Receiver".

$2,500 flat fee per "Receiver"

New Optional Electronic HIPAA Billing Module for Private Insurance.

Electronic submissions for Private Insurance has not been supported in the IMA system before as many private insurance plans did not accept electronic submissions up to now.
When HIPAA goes into effect however, all plans will be required to accept electronic claims either directly or through a clearinghouse. This new IMA module may therefore become attractive to some agencies.
The $5,000 fee for this module covers the module and also covers the setup and testing for the first such PI "Receiver". Therefore, if a clearinghouse is used, this fee would cover the full cost of electronic submissions to all PI plans using that clearinghouse.

available for $5,000

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