Data Testing with MedAssets

There were two CMS deadlines for vendors conducting 5010 Compliance testing. Level I 5010 compliance did not require client, trading partner and payor interaction, while Level II 5010 compliance required external data testing.

The MedAssets Claims Management (and related modules), Denial Manager and Collections Management solutions contain functionality that translates claims data, remittance data, eligibility and claims status that required MedAssets to conduct Level II testing with client data. No other MedAssets solution required testing to meet Level II compliance.

Our testing also extended to our extensive payor network. MedAssets is continuing to work aggressively with payors to obtain, incorporate and test items and rules essential for successful client claims transmissions and sustained clean claim rates. We also are proactively engaging with payors to identify certain items and rules required for our clients’ successful transition.

Our goal for 5010 client testing is to support achieving compliance without disruption to clean claim rates. Our 5010 client testing process addresses those items most common to cause edit issues and claim rejections. MedAssets clients should be aware that payor readiness and interpretation of the 5010 Implementation Guide may have an impact to the claim acceptance and payment rate at the payor stage. MedAssets will continue to work with clients and payors to help identify and resolve such claim impacts.