MedCost, LLC Physicians & Providers

As a participating provider in the MedCost network, you are the backbone of our PPO product. The tools on this website are provided to support and assist you in working with MedCost on behalf of our patients. For your protection, and to ensure patient privacy, security measures are in place to monitor access to certain features.

Deadlines for 5010 Electronic Transactions and ICD-10 Code Sets

MedCost has established an internal task force to address the technical and business changes necessary to implement HIPAA 5010 electronic transaction standards and ICD-10 code sets, and we will be fully compliant by the required dates as published in the Federal Register:

Deadline for 5010 electronic transactions – January 1, 2012

Deadline for ICD-10 code sets – October 1, 2013

To ensure timely provider reimbursement, please be aware of the following stipulations:

Any transactions submitted to MedCost on or after 1/1/12 that are not in the 5010 format will not be accepted.

MedCost will only accept claims with ICD-10 codes for services rendered on or after 10/1/2013. (This includes ICD-10-CM and ICD-10-PCS.)

Click here for more information and recommendations on how you can prepare for 5010.

New Requirements for Preventive Services as Part of PPACA

As part of the Patient Protection and Affordable Care Act (PPACA), the Departments of Health and Human Services (HHS), Labor, and Treasury recently issued interim final regulations requiring group health plans and group health insurance issuers to cover certain preventive services without any cost-sharing to the member when delivered by in-network providers.

These requirements may change how providers file claims for preventive services and also could affect the time it takes to process a claim for payment. In all likelihood, many payers will pend claims related to preventive services for additional information.

For additional information, click here.

Support Inclusive Health- State and Federal Options
If you are a North Carolina MedCost participating provider and would like more information about joining the Inclusive Health Network (North Carolina Health Insurance Risk Pool), click here.






	As a participating provider in the MedCost network, you are the backbone of our PPO product. The tools on this website are provided to support and assist you in working with MedCost on behalf of our patients. For your protection, and to ensure patient privacy, security measures are in place to monitor access to certain features. Deadlines for 5010 Electronic Transactions and ICD-10 Code Sets MedCost has established an internal task force to address the technical and business changes necessary to implement HIPAA 5010 electronic transaction standards and ICD-10 code sets, and we will be fully compliant by the required dates as published in the Federal Register: Deadline for 5010 electronic transactions – January 1, 2012 Deadline for ICD-10 code sets – October 1, 2013 To ensure timely provider reimbursement, please be aware of the following stipulations: Any transactions submitted to MedCost on or after 1/1/12 that are not in the 5010 format will not be accepted. MedCost will only accept claims with ICD-10 codes for services rendered on or after 10/1/2013. (This includes ICD-10-CM and ICD-10-PCS.) Click here for more information and recommendations on how you can prepare for 5010. New Requirements for Preventive Services as Part of PPACA As part of the Patient Protection and Affordable Care Act (PPACA), the Departments of Health and Human Services (HHS), Labor, and Treasury recently issued interim final regulations requiring group health plans and group health insurance issuers to cover certain preventive services without any cost-sharing to the member when delivered by in-network providers. These requirements may change how providers file claims for preventive services and also could affect the time it takes to process a claim for payment. In all likelihood, many payers will pend claims related to preventive services for additional information. For additional information, click here. Support Inclusive Health- State and Federal Options If you are a North Carolina MedCost participating provider and would like more information about joining the Inclusive Health Network (North Carolina Health Insurance Risk Pool), click here.

















Copyright 2006 MedCost, LLC Updated April 12, 2011