Published on June 19, 2013
in Clearinghouse - ACTION REQ.
The clearinghouse would like to inform providers of an important update for the conversion of CPIDs 1480 and 3564 North Carolina Medicaid from HPES/ECS to NCTracks on July 1, 2013. To meet the payer's claim cutoff time of 4:00 PM CT on 6/20/2013, claims must be submitted to the clearinghouse no later than 12:00 PM CT on 6/20/2013. This time has changed since previously communicated on 6/18/2013. The clearinghouse will be holding all claims submitted after this date until the dark days end.
Please refer to the updated information below:
• 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 4:00 PM CT
o Claims must be submitted to the clearinghouse no later than 12:00 PM CT on 6/20/2013 to meet the payer's cutoff time
• 6/27/2013 Last day HPES/ECS will produce electronic remittance
• 7/1/2013 First day NCTracks will accept transactions as of 5:00 AM CT
• 7/9/2013 Approximate date first electronic remittance will be available
• For electronic claims: from 12:00 PM CT on 6/20/2013 through 5:00 AM on CT 7/1/2013. The clearinghouse will hold claims during this time and will begin submitting claims after 5:00 AM CT on 7/1/2013.
• For electronic remittance: from 6/27/2013 through approximately 7/9/2013
• Billing Provider Taxonomy Code is required 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 6/21/2013.
• Rendering Provider Taxonomy Code is required when the associated NPI or Atypical Provider ID is present or claims will reject with edit PRV0325EW for Professional claims. Providers may begin submitting Rendering Provider Taxonomy Codes now to avoid rejections on or after 6/21/2013.
• Attending Provider Taxonomy Code is required when the associated NPI or Atypical Provider ID is present or claims will reject with edit IPRV0325EW for Institutional claims. Providers may begin submitting Attending Provider Taxonomy Codes now to avoid rejections on or after 6/21/2013.
• The 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.
• Providers already approved to submit transactions through the clearinghouse do not need to complete a new agreement but must register in NCTracks by June 24, 2013 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. If NCTracks registration is not completed by June 24, 2013 providers will have to wait until July 1, 2013 when the NCTracks Provider Portal is available to complete registration.
• New providers will need to complete a new agreement and must register in NCTracks. 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 and indicate "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 6/24/2013 to reflect the Billing Agent name only as "RELAYHEALTH".
Action required: Please ensure claims are submitted to the clearinghouse no later than 12:00 PM CT on 6/20/2013.
If you have any questions, please contact Client Services at 1-888-348-8457, option 2.