CollaborateMD Blog

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.

Update: Invalid Error Message for Multiple CPIDs

Wed, 22 May 2013 16:50:57 +0000

Update: This issue is also affecting the following payer:CPID 3507 Ohio MedicareOriginal Notification Sent 05/21/2013:Due to a Palmetto GBA 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): A7:510 - Future DateA7:187 - Date(s) of ServiceThis issue began on 05/20/2013. We are currently working with Palmetto GBA to resolve this issue. Payers affected: CPID 1436 Northern California Medicare CPID 1444 Southern California MedicareCPID 1446 Nevada MedicareCPID 1450 West Virginia MedicareCPID 1464 North Carolina MedicareCPID 1560 South Carolina MedicareCPID 2452 South Carolina MedicareCPID 2467 Hawaii/Guam MedicareCPID 2676 J1 Mutual of Omaha California, Nevada, HawaiiCPID 3508 California MedicareCPID 3563 North Carolina MedicareCPID 3597 RHHI Home Health Medicare Region IV (Gulf Coast/Midwest)CPID 4958 RHHI Home Health Medicare Region IV (Midwest)CPID 5544 RHHI Home Health Medicare (SW/SE)CPID 5567 Hawaii MedicareCPID 5907 Nevada MedicarePlease be aware of the invalid rejection messages. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Wells Fargo Third Party Administrators No Longer Offering Electronic Eligibility

Wed, 22 May 2013 16:49:10 +0000

The clearinghouse has been notified that Wells Fargo Third Party Administrators no longer offers electronic eligibility. As a result, the clearinghouse will remove Payer ID ACORDN from our active payer list effective immediately.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Update: Payer Transmit Delay for CPIDs 1482 and 5523 Washington Medicaid

Wed, 22 May 2013 16:46:49 +0000

Update: This issue has been resolved and claims were transmitted to the payer on 05/21/2013. Original Notification Sent 05/20/2013:Due to a payer system issue, a delay occurred in the transmission to the following payer from the clearinghouse on 05/17/2013: CPID 1482 Washington Medicaid CPID 5523 Washington Medicaid The clearinghouse is working to resolve this issue. We will notify you as soon as additional information becomes available. This delay has affected claims released to the clearinghouse since 3:00 PM CT on 05/16/2013.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Multiple Payers No Longer Offering Electronic Connection

Wed, 22 May 2013 10:48:43 +0000

The following payers are no longer offering an electronic connection: CPID: 5644Payer Name: Kentucky Health Administrators5010 Institutional ClaimsTermination Date: 05/20/2013CPID: 1946Payer Name: Transamerica Life Insurance Company5010 / Institutional RemittanceTermination Date: 05/21/2013 CPID: 2892Payer Name: Transamerica Life Insurance Company5010 / Professional RemittanceTermination Date: 05/21/2013 The clearinghouse will continue to accept paper claims using paper CPID 4300 for Professional commercial claims or CPID 4350 for Institutional commercial claims. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Upcoming Payer Conversion for Multiple CPIDs

Wed, 22 May 2013 10:42:40 +0000

Independence Blue Cross (IBC) and Independence Administrators have announced that they will be migrating the following payers to Highmark Gateway. The clearinghouse is currently working to obtain transition details and will send additional notifications as soon as they are available.CPID 7417 Pennsylvania Independence Keystone Health Plan East - HMO - Payer ID 95056CPID 3559 Pennsylvania Independence Keystone Health Plan East - HMO - Payer ID 95056CPID 2781 Pennsylvania Independence Blue Cross - Payer ID 54704CPID 3560 Pennsylvania Independence Blue Cross - Payer ID 54704CPID 3557 Pennsylvania Independence Amerihealth HMO - Payer ID 95044CPID 3558 Pennsylvania Independence Amerihealth PPO - Payer ID 60061CPID 4715 Pennsylvania Independence Amerihealth DE - PPO - Payer ID 93688CPID 4716 Pennsylvania Independence Amerihealth NJ - PPO - Payer ID 60061Providers must be aware of the following: Payer ID changes: The Payer IDs are not changing for this payer conversion. Enrollment Changes: Payer agreements for electronic claims are required.Providers already approved to submit transactions through the clearinghouse do not need to complete a new agreement. New providers need to complete a new agreement.Payer agreements for electronic remittance are required. Providers already approved to receive remittance advice through the clearinghouse do not need to complete a new agreement. New providers need to complete a new agreement.Action Required: None at this time, however, providers should be aware of the transition and watch for future notifications regarding this transition. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Top Benefits of Electronic Health Records

Tue, 21 May 2013 18:53:02 +0000

There are so many benefits to transitioning over to using Electronic Health Records and CollaborateMD is here to assist in any questions that you may have.The first and one of the most important is legibility. We all know and have heard jokes about the legibility of some doctor's handwriting, but handwriting, is generally much less readable than typed records. Illegible records can be a cause of patient mistreatment. Illegible handwriting can also lead to inaccurately filled prescriptions. Legibility, and how it can prevent medical errors, is one of the key pros for the implementation of EHR.As the health and safety of the patient is always first and foremost, it is important to also consider how easily read medical records can assist your practice in maximizing your claim reimbursement in many ways.All Commercial payers, as well as CMS, reserve the right to deny any service they see as not reasonable and necessary.By utilizing an EHR system, you can avoid claim payment denials by having clear clinical notes and supporting documentation. The EHR system will automatically assign the date, time and appropriate service provider to the medical record. It will also update this information as necessary when changes are made to the record insuring complete and accurate tracking of the patient's treatment process.In many instances, an EHR can guide you through a process, prompting the provider to fully complete one part of the evaluation before moving on to the next.As an EHR many times is completed real time with the patient face to face, it will record all procedures and services performed. When this record is reviewed by the medical coder, all appropriate procedure codes can be collected and billed, which will eliminate any missed checkmarks on old bills.So, when you have decided it's time to select your EHR, keep something else in mind. The ability of your EHR to communicate electronically with yourmedical billing software. At CollaborateMD, we are here to help guide you through this process and answer any questions you may have.

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.

Invalid Error Message for Multiple CPIDs

Tue, 21 May 2013 17:22:10 +0000

Due to a Palmetto GBA 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): A7:510 Future DateA7:187 Date(s) of ServiceThis issue began on 05/20/2013. We are currently working with Palmetto GBA to resolve this issue. Payers affected: CPID 1436 Northern California Medicare CPID 1444 Southern California MedicareCPID 1446 Nevada MedicareCPID 1450 West Virginia MedicareCPID 1464 North Carolina MedicareCPID 1560 South Carolina MedicareCPID 2452 South Carolina MedicareCPID 2467 Hawaii/Guam MedicareCPID 2676 J1 Mutual of Omaha California, Nevada, HawaiiCPID 3508 California MedicareCPID 3563 North Carolina MedicareCPID 3597 RHHI Home Health Medicare Region IV (Gulf Coast/Midwest)CPID 4958 RHHI Home Health Medicare Region IV (Midwest)CPID 5544 RHHI Home Health Medicare (SW/SE)CPID 5567 Hawaii MedicareCPID 5907 Nevada MedicarePlease be aware of the invalid rejection messages. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Payer Transmit Delay for CPIDs 1482 and 5523 Washington Medicaid

Tue, 21 May 2013 17:20:24 +0000

Due to a payer system issue, a delay occurred in the transmission to the following payer from the clearinghouse on 05/17/2013: CPID 1482 Washington Medicaid CPID 5523 Washington Medicaid The clearinghouse is working to resolve this issue. We will notify you as soon as additional information becomes available. This delay has affected claims released to the clearinghouse since 3:00 PM CT on 05/16/2013.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.

The Clearinghouse Is No Longer Providing 999 Payer Reports for Multiple CPIDs

Tue, 21 May 2013 17:09:52 +0000

To streamline the process for resubmitting "clean" claims from a rejected claim/file, the clearinghouse is changing the process for reporting payer file level rejected claims. The clearinghouse will no longer provide the 999 payer report to identify payer file level rejections. Instead, when the clearinghouse receives a rejected claim/file from a payer, the clearinghouse will automatically resubmit the "clean" claims (those that do not have errors) immediately upon receiving the 999 transaction from the payer (if applicable).This change ensures that clean claims not processed by the payer due to a file level rejection are resubmitted immediately.Payers Impacted:CPID 7475 Medicare DME MAC Jurisdiction ACPID 7476 Medicare DME MAC Jurisdiction BCPID 7477 Medicare DME MAC Jurisdiction CCPID 7478 Medicare DME MAC Jurisdiction DPlease be aware that you will no longer receive a 999 payer report, effective immediately. You will continue receiving a FX Report notifying you of claims that rejected on the payer's 999. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Update: This issue has been resolved. All impacted ERA have been received and processed.

Mon, 20 May 2013 13:23:28 +0000

Update: This issue has been resolved. All impacted ERA have been received and processed. Original Notice Sent 05/17/2013: Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates 05/10/2013 through present:CPID 2824 The Health PlanCPID 7551 The Health PlanAdditional updates will be forwarded as more information becomes available. Please be aware of a delay in the delivery of ERA for file dates above.If you have any questions, please contact Client Services at 1-888-348-8457, option 2.

Upcoming CMS Jurisdiction 6 Medicare Contractor Change

Mon, 20 May 2013 10:46:29 +0000

The Centers for Medicare and Medicaid Services (CMS) has awarded the Medicare Administrative Contractor (MAC) Jurisdiction 6 contract to National Government Services (NGS). The clearinghouse is currently working with NGS to obtain transition details and will send additional notifications as soon as they are available. Providers must be aware of the following: CPID: 1437Payer Name: Illinois Medicare Part BTransition Date: 09/07/2013Current MAC: Wisconsin Physician Services (WPA)Old Payer ID: 00952New Payer ID: 06102CPID: 1434Payer Name: Wisconsin Medicare Part B Transition Date: 09/07/2013Current MAC: Wisconsin Physician Services (WPA)Old Payer ID: 00951New Payer ID: 06302CPID: 1435Payer Name: Minnesota Medicare Part BTransition Date: 09/07/2013Current MAC: Wisconsin Physician Services (WPA)Old Payer ID: 00954New Payer ID: 06202Providers must be aware of the following:Payer ID changes: Providers only need to include the CPID (not Payer ID) in the claim. The clearinghouse will manage the Payer ID changes for our customers.Enrollment Changes:Payer agreements for electronic claims are required.Providers already approved to submit transactions through the clearinghouse do not need to complete a new agreement. New providers need to complete a new agreement.Payer agreements for electronic remittance are required. Providers already approved to receive remittance advice through the clearinghouse do not need to complete a new agreement. New providers need to complete a new agreement.Payer agreements for Electronic Funds Transfer (EFT) are required. Providers that have existing electronic funds transfer agreements with current fee-for-service (FFS) contractors are not required to submit a new CMS-588 EFT Authorization Agreement form. New providers need to complete a new agreement. NGS has established a Medicare A/B Jurisdiction 6 Implementation website http://www.ngsmedicare.com that contains Jurisdiction 6 Transition Information. Action Required: None at this time, however, providers should be aware of the transition and watch for future notifications regarding this transition. 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.