Testing of new 5010 transactions is a process designed to allow submitters to verify their data is compliant with the Arkansas Blue Cross and Blue Shield front-end and processes. It is each submitter’s responsibility to utilize the process developed by Arkansas Blue Cross and Blue Shield and its family of companies in order to avoid payment interruption.

Prior to moving a submitter’s claims file into production each Arkansas Blue Cross and Blue Shield and its family of companies’ submitter must complete testing. The Arkansas Blue Cross and Blue Shield and its family of companies test process is defined as the following;

1. Submitters must complete the 5010 testing contact form before sending a test file.
2. Submitters should always use claims from their practice specialty, including real patient information.
3. After a test file has been submitted, it is the submitter’s responsibility to review all reports returned to that submitter.
4. Standard syntax testing validates the programming of the incoming file and includes file layout, record sequencing, balancing, alpha-numeric/numeric/date file conventions, field values, and relational edits. Test files must pass 100 percent of the standard syntax edits before production is approved.
5. IG Semantic Data testing validates data required for claims processing, e.g., procedure/diagnosis codes, modifiers. A submitter must demonstrate, at a minimum, a 95 percent accuracy rate in data testing before production is approved where, in the judgment of Arkansas Blue Cross and Blue Shield and its family of companies, the vendor/submitter will make the necessary correction(s) prior to submitting a production file.
6. All submitters must test the specialty claim types indicative of their practices and the claim types must be a vast representative of the specialty claim types that will be submitted in production mode.
7. All submitters must submit a file containing no less than 25 claims and no more than 100 claims. It is recommended submitters who have multiple specialties send test files for each category.
8. When a submitter has completed the above mentioned criteria, and is satisfied with their results, they must complete the 5010 Move to Production for Arkansas Blue Cross and Blue Shield and its family of companies.

I hereby agree to the term and conditions of the Arkansas Blue and Blue Shield and its family of companies’ 5010 testing process and agree to abide with said terms and conditions. I am hereby authorized by my facility to accept these terms.