RELEASE NOTES - SOS Electronic Claims Module (5010)
Last Revised: 05/17/2012
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2010.01: Changes, Additions, and Fixes Since Initial Release of the 5010 Formatter
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05/17/12

• FIX: Corrected the 2320 SBR05 segment for Medicare secondary. This segment will get a value of 47 unless user overrides that default with an entry in User-Defined field 5 for the secondary Medicare policy.

04/10/12

• CHANGE: When reading a downloaded 999 file, if the original claim is not found in the main CLAIMS folder, SOS now searches the claims ARCHIVE folder for a match. If found, the file is restored to the main CLAIMS folder so the 999 can be interpreted.
• FIX: Attempts to format institutional claims would produce professional format claims instead.
• CHANGE: If it is determined that the downloaded 999 matches a claim in a different dataset, we let you know which dataset you should go to in order to translate the 999.
• FIX: Restored the command line configuration to correctly call the 5010 format. 
• FIX: Corrected an error processing the SBR (Subscriber) segment.

• FIX: Acknowledgement reports (999 and 277) now show in list for Maryland Medicare.
• CHANGE: Zipcodes in the ECM Setup window are now all 9 digits.

• CHANGE: Removed some setup options that are now obsolete.
• NEW: Now able to translate the new 5010 - 999 and 277 reports.
• FIX: Facility data that had been in the 2310d loop has been moved to the 2310C loop in the 5010 claims.
• FIX: Previously translated reports were getting re-translated over and over.
• FIX: Florida Medicare 999's were not finding the correct claim match without manual intervention. Now matches to claim automatically as it should.
• CHANGE: Florida Medicare direct filers now have an option on the ECM Setup screen to retrieve all waiting reports or retrieve reports individually by type (TA1, 999, or 277).

• NEW: Added 2010AA Special Tax ID Ref for payors that need provider tax ID in segment 2010AA.

• NEW: Added extra REF IDs in segment 2310B for special payors requirements

• CHANGE: Added code to display errors tab after building the 837 only if there are errors.

• FIX: Removed code section that was related to THIN that is no longer relevant in segment 2010BB

• CHANGE: Made changes in LP2330B Ref segment for Ohio MACSIS and cleaned up code in LP2310B.
• CHANGE: Made changes for Ohio MACSIS switch in loop 2330A and loop 2330B

• FIX: Re-enabled emdeon site ID for better reporting.
• FIX: Modified segment 2310D Ref where it would generate a G5 reference (site id) which is valid in 2010AA, but when the provider is a supervising provider, the G5 info is still being passed. Added a trap to prevent the creatin of a REF segment when the ID qualifier is 'G5' even when submitting to emdeon because it causes rejection.

• FIX: No longer creates segment 2330B-DTP (remittance date) if the same date is present in the service details, 2430-DTP (remittance date).
• FIX: If  command line contains '/2310B' or the NPI of rendering provider is different from the NPI of the supplier/pay-to provider, then segment 2310B will be created. Otherwise, 2310B will no longer be created.

• FIX: Suppress creation of facility segment in loop 2400 (service details) if same as in 2300 loop (claim) unless forced with /sw2310B command line switch.

• FIX: Secondary coverage - If group number and plan name are both available, include only the number on the claim. 
• FIX: Omit SBR-04 if SBR-03 is present in 2000B loop. (Subscriber info)

• CHANGE: Ohio MACSIS claim files - provides for naming the output 837-5010 with a different filename prefix (W).
• CHANGE: Report file viewer so user can examine raw 999, 277, or TA1 response files (Florida Medicare).
• ADDED: Button on file viewer window to display internet page that translates 277 error codes.

• FIX: Error in claim formatter for secondary coverage pay-to provider.
• FIX: If group number and plan name are both available, include only the number on the claim

• FIX: Relationship to insured set to 19 was not mapped correctly under certain circumstances.
• FIX: Relationship to insured not set correctly in secondary (Loop 2320, segment SBR-02).

• FIX: Claim generation did not handle batch option "Do not include other coverage info for box 9" correctly if policy was not in top position in OM list of patient's policies.

• FIX: Bogus error report in claim formatter for missing Claim Adjustment Reasons (CARs).
• FIX: Onset date in claim loop (2300) should be omitted. Date in service lines (2400 loop) will suffice.

• FIX: OI-06 (signature on file) segment. Code change for 5010. "N" no longer valid; should be "I".

• FIX: General failure because of missing data when creating N4 segment.

• FIX: Submitter zip code in the ECM Setup screen of the formatter changed to accept a 9 digit zip code.

• FIX: Ohio MACSIS claims - syntax error when checking for MACSIS switch. Software did not recognize that user had set the switch to generat MACSIS claims.

• FIX: Place of service should not be specified in service details (SV1-05) if same as place of service set in claim loop 2300.

• FIX: Added trap for Supplier addresses with empty fields (eg: no street address entered). The missing data caused segment creation errors in the 837 output for loop 2010AB.