CollaborateMD Blog

Payer ID Change

Fri, 24 May 2013 15:05:56 +0000

Effective 5:00 PM CT on 5/29/2013, the Payer ID for CPIDs 6189 and 4661 Lockard and Williams is changing from 43471 to CB752. This payer is no longer associated with Inetico, Inc. which handles claims using Payer ID 43471. CPID: 6189Payer Name: Lockard and Williams5010 Professional ClaimsPayer Enrollments Required: NoPayer Location: NationalCurrent Payer ID: 43471New Payer ID: CB752CPID: 4661Payer Name: Lockard and Williams5010 Institutional ClaimsPayer Enrollments Required: NoPayer Location: NationalCurrent Payer ID: 43471New Payer ID: CB752 Effective immediately, the following new electronic connection is available for Inetico, Inc. Payer ID 43471. Please make the necessary system updates before 5/29/2013 to begin using CPIDs 6460 and 5673 for Inetico, Inc. claims.CPID: 6460Payer Name: Inetico, Inc.5010 Professional ClaimsPayer Enrollments Required: NoPayer Location: NationalPayer ID: 43471CPID: 5673Payer Name: Inetico, Inc.5010 Institutional Claims Payer Enrollments Required: NoPayer Location: NationalPayer ID: 43471Action Required: Please make the above changes to accommodate the Payer ID change and new electronic connection. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Kentucky Medicaid is Currently Unable to Process Eligibility Transactions

Thu, 23 May 2013 12:45:41 +0000

Kentucky Medicaid is currently unable to process eligibility transactions. To avoid potential transaction processing fees and disruptions to the payer's resolution plan, we recommend that you hold all eligibility transactions for this payer until this issue is resolved. The payer is working to restore service as quickly as possible. Action Required: Please hold all eligibility transactions for this payer until this issue is resolved.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

New Payer Edit for CPIDs 1639 and 5701 Martin’s Point Health Care USFHP/Generations Advantage

Thu, 23 May 2013 12:41:55 +0000

The payer listed below has informed the clearinghouse of a new edit requirement effective immediately. In order to meet the new requirement, the clearinghouse added the following edits on 05/23/2013:INM10905DZ: INVALID SUBSCRIBER MEMBER ID - When entered, the Active Subscriber Member ID must be 11 characters in length and begin with either 0 (zero) or 1.PNM10905DZ: INVALID SUBSCRIBER MEMBER ID - When entered, the Active Subscriber Member ID must be 11 characters in length and begin with either 0 (zero) or 1.Edit applies to:CPID 5701 Martin's Point Health Care USFHP/Generations AdvantageCPID 1639 Martin's Point Health Care USFHP/Generations AdvantageAction Required: Please be aware of updated edit requirements.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

South Carolina Blue Cross Blue Shield Currently Unable to Process Eligibility Transactions

Wed, 22 May 2013 16:52:28 +0000

South Carolina Blue Cross Blue Shield is currently unable to process eligibility transactions. To avoid potential transaction processing fees and disruptions to the payer's resolution plan, we recommend that you hold all eligibility transactions for this payer until this issue is resolved. The payer is working to restore service as quickly as possible. Action Required: Please hold all eligibility transactions for this payer until this issue is resolved.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

North Carolina Medicaid is Currently Unable to Process Eligibility Transactions

Tue, 21 May 2013 17:23:49 +0000

North Carolina Medicaid is currently unable to process eligibility transactions. To avoid potential transaction processing fees and disruptions to the payer's resolution plan, we recommend that you hold all eligibility transactions for this payer until this issue is resolved. The payer is working to restore service as quickly as possible. Action Required: Please hold all eligibility transactions for this payer until this issue is resolved.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Update: Upcoming Payer Conversion for CPIDs 1480 and 3564 North Carolina Medicaid

Tue, 21 May 2013 17:18:05 +0000

The clearinghouse would like to inform providers of updates for the conversion of CPIDs 1480 and 3564 North Carolina Medicaid to NCTracks on July 1, 2013. The clearinghouse is currently working to obtain transition details and will send additional notifications as soon as they are available.Providers must be aware of the following:Enrollment Changes:As of 5/31/2013, the clearinghouse will no longer enroll providers for electronic claims or remittance through the current processor in order to prepare for the conversion to NCTracks. We will provide additional notification when the enrollment forms are available on Collaboration Compass.Providers already approved to submit transactions through the clearinghouse do not need to complete a new agreement but must register in NCTracks and select "RELAYHEALTH" from the Billing Agent drop down field. Providers have been sent a letter from North Carolina Department of Health and Human Services (DHHS) with instructions for registering in NCTracks. If you have not received your letter, call 866-844-1113.New providers will need to complete a new agreement when the forms are available on Collaboration Compass. Providers will be sent a letter from DHHS with instructions for registering in NCTracks. When registering in NCTracks select "RELAYHEALTH" from the Billing Agent drop down field. Providers must register in NCTracks by July 1, 2013 indicating "RELAYHEALTH" as their Billing Agent and select the appropriate transactions for electronic claims or remittance. Providers will only be allowed to select one Billing Agent for Claims and Remittance prior to 7/1/2013. After 7/1/2013, providers will be allowed to modify their Billing Agents by transaction. Letters will be sent to providers by the payer with instructions for updating Billing Agents at a later date.It is important for providers to select "RELAYHEALTH" from the Billing Agent drop down field at the time of registration. If providers keyed "RELAYHEALTH" rather than selecting from the drop down field, please ensure the Billing Agent was keyed only as "RELAYHEALTH". If any variation of the name or a value other than "RELAYHEALTH" was keyed, your claims will not be linked to the clearinghouse, therefore causing claims to reject and/or delay in remittance delivery. Please review the Billing Agent selection and make necessary updates prior to 7/1/2013 to reflect the Billing Agent name only as "RELAYHEALTH".Transition Schedule -5/31/2013 Last day the clearinghouse will accept electronic claims and remittance enrollments for HPES/ECS-6/12/2013 Last day HPES/ECS will accept paper claims-6/20/2013 Last day HPES/ECS will accept electronic claims submissions as of 4:00pm CTClaims must be submitted to the clearinghouse by 1:30pm CT on 6/20/2013 to meet the payers cutoff time-6/27/2013 Last day HPES/ECS will produce electronic remittance-7/1/2013 First day NCTracks will accept transactions as of 5:00am CT-7/9/2013 approximate date first electronic remittance will be availableDark Days For electronic claims: from 6/20/2013 1:30pm CT through 7/1/2013 5:00am CT. The clearinghouse will hold claims during this time and will begin submitting claims after 5:00am CT on 7/1/2013.For electronic remittance: from 6/27/2013 through approximately 7/9/2013.Edit ChangesBilling Provider Taxonomy Code is required when 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 7/1/2013.Rendering Provider Taxonomy Code or Attending Provider Taxonomy Code is required when the associated NPI or Atypical Provider ID is present or claims will reject. Providers may begin submitting Rendering or Attending Provider Taxonomy Codes now to avoid rejections on or after 7/1/2013.The NCTracks system uses NPI, taxonomy codes, and location to process and pay claims. Providers are encouraged to verify their taxonomy codes and locations at http://ncmmis.ncdhhs.gov/taxonomy.asp before July 1. Claims submitted in NCTracks with codes that do not match your provider taxonomy will be denied.ReportsThe clearinghouse will no longer receive claim level information for Standardized Reporting on or after July 1, 2013. Claim updates will be returned either in an 835 Electronic Remittance File; or in an Explanation of Benefits (EOB) pdf file available through NCTracks provider portal. Action Required: Providers must register in NCTracks by July 1, 2013 indicating "RELAYHEALTH" as their Billing Agent and select the appropriate transactions for electronic claims or remittance. Providers will only be allowed to select one Billing Agent for Claims and Remittance prior to 7/1/2013. After 7/1/2013, providers will be allowed to modify their Billing Agents by transaction. Letters will be sent to providers by the payer with instructions for updating Billing Agents at a later date.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

New York Excellus Blue Cross Blue Shield Eligibility Transaction Processing Issue Resolved

Mon, 20 May 2013 10:35:31 +0000

New York Excellus Blue Cross Blue Shield has resolved its processing issues and can now process eligibility transactions. Action Required: Please resume sending eligibility transactions to this payer.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

New York Excellus Blue Cross Blue Shield is Currently Unable to Process Eligibility Transactions

Fri, 17 May 2013 16:16:56 +0000

New York Excellus Blue Cross Blue Shield is currently unable to process eligibility transactions. To avoid potential transaction processing fees and disruptions to the payer's resolution plan, we recommend that you hold all eligibility transactions for this payer until this issue is resolved. The payer is working to restore service as quickly as possible. Action Required: Please hold all eligibility transactions for this payer until this issue is resolved.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

New Mexico Medicaid Electronic Eligibility Changes

Fri, 17 May 2013 16:14:27 +0000

New Mexico Medicaid has supplied updated information regarding eligibility search options:Prior Search Options: 1. Member ID 2. Card Control Number3. Social Security Number / Date of Birth 4. Social Security Number / Last Name / First Name5. Last Name / First Name / Date of Birth / Gender CodeUpdated Search Options:1. Member ID 2. Social Security Number / Date of Birth 3. Social Security Number / Last Name / First Name 4. Last Name / First Name / Date of Birth / Gender CodeThe payer will become 5010 compliant by the end of the day on Friday, May 17, 2013.Action Required: Submit eligibility requests to this payer using the noted search options. These search option changes take effect immediately.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Providence Health Plan (OR) Electronic Eligibility Changes

Fri, 17 May 2013 16:01:04 +0000

Providence Health Plan (OR) has supplied updated information regarding eligibility search options:Prior Search Options: 1. Member ID2. Last Name / First Name / Date of Birth3. Member ID / First Name / Middle Name / Date of Birth Updated Search Options:1. Member ID / Last Name / First Name2. Member ID / Last Name / Date of Birth3. Member ID / First Name / Date of BirthThe payer will become 5010 compliant by the end of the day on Friday, May 17, 2013.Action Required: Submit eligibility requests to this payer using the noted search options. These search option changes take effect immediately.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Oregon Medicaid Eligibility Transaction Processing Issue Resolved

Fri, 17 May 2013 09:26:32 +0000

Oregon Medicaid has resolved its processing issues and can now process eligibility transactions. Action Required: Please resume sending eligibility transactions to this payer.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Oregon Medicaid Currently Unable to Process Eligibility Transactions

Thu, 16 May 2013 16:36:42 +0000

Oregon Medicaid is currently unable to process eligibility transactions. To avoid potential transaction processing fees and disruptions to the payer's resolution plan, we recommend that you hold all eligibility transactions for this payer until this issue is resolved. The payer is working to restore service as quickly as possible. Action Required: Please hold all eligibility transactions for this payer until this issue is resolved.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Invalid Error Message for Multiple CPIDs

Thu, 16 May 2013 16:35:29 +0000

Due to a payer processing issue, Professional and Institutional claims for the payers listed below may have received the following invalid error message on the Payer Claim Data Report (SR):Rejection code A3:218This issue began on 04/11/2013 and was resolved by Cigna on 04/26/2013. Claims submitted during that time frame that received rejection code A3:218 must be resubmitted. Cigna apologizes for any inconvenience.Payers affected are: CPID 4509 Cigna Health PlansCPID 4516 Cigna SelectCPID 6405 Cigna Health PlansCPID 6408 Cigna SelectAction Required: Claims submitted from 04/11/2013 to 04/26/2013 that received rejection code A3:218 must be resubmitted.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Payer Scheduled Maintenance-Arizona Blue Cross Blue Shield

Thu, 16 May 2013 11:15:34 +0000

Arizona Blue Cross Blue Shield has scheduled maintenance at the following time:1:00 PM CT to 4:00 PM CT on Saturday, 05/18/2013During this time frame, eligibility transactions should not be sent. Transactions sent during the scheduled maintenance time frame above may receive a response stating: Unable to Respond at Current Time.Action Required: Do not send eligibility transactions to this payer at the time listed above.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Payer Scheduled Maintenance – Rhode Island Blue Cross Blue Shield

Thu, 16 May 2013 11:14:10 +0000

Rhode Island Blue Cross Blue Shield has scheduled maintenance at the following time:9:00 PM CT on Saturday, 05/18/2013 to 9:00 PM CT on Sunday, 05/19/2013During this time frame, eligibility transactions should not be sent. Transactions sent during the scheduled maintenance time frame above may receive a response stating: Unable to Respond at Current Time.Action Required: Do not send eligibility transactions to this payer at the time listed above.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.