The clearinghouse would like to inform providers of updates and upcoming dark days for CPIDs 4489 and 5524 Alaska Medicaid
conversion to Health Enterprise on October 1, 2013.
• 9/16/2013 Last day for submission of electronic claims
o Claims must be submitted to the clearinghouse no later than 3:00 PM CT on 9/16/2013 to meet the payer's cutoff time
• 9/17/2013 Last financial cycle in legacy system for claims received by 9/16/2013 cutoff; claims not paid will be denied
• 10/1/2013 First day for submission to Health Enterprise
• For electronic claims, from 3:00PM CT on 9/16/2013 through 10/1/2013
• For electronic remittance, from 9/17/2013 through 10/8/2013
• Billing Provider Taxonomy is required when the associated NPI is present or claims will reject with edit PPRV0318EW for Professional claims and edit IPRV0313EW for Institutional claims. Providers may begin submitting Billing Provider Taxonomy Codes now to avoid rejections on or after 9/17/2013.
• Rendering Provider Taxonomy is required when the associated NPI is present and is different than the Billing Provider NPI or claims will reject with edit PPRV0324EW for Professional claims. Providers may begin submitting Rendering Provider Taxonomy Codes now to avoid rejections on or after 9/17/2013.
• Billing Provider Address must contain the physical address or claims will reject with edit PN3-0115EB or PN3-020137 for Professional claims and edit IN3-010337 or IN3-020337 for Institutional claims.
Lock Box and PO Box addresses will not be accepted.
• The Billing and Rendering Provider Taxonomy Codes must match provider enrollment records or payer will suspend claims.
• The Billing Provider and Service Facility Address and ZIP Codes must match provider enrollment records or payer will suspend claims.
• The Billing Provider and Service Facility nine digit ZIP Codes containing '0000' or '9999' as the last four digits will now receive a warning and may delay claim payment. Nine digit ZIP codes can be found on the USPS website: http://zip4.usps.com
Providers must send the correct taxonomies, addresses and ZIP codes from their enrollment record. Please verify correct information is submitted on claims to prevent claim and/or remittance delays.
If you have any questions, please contact Client Services at 1-888-348-8457, option 2.