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Blue Cross Blue Shield of Kansas EDI Services
Vendor Call Minutes

July 19, 2007

General Announcements:

    • As a reminder, providers wanting access to the On-Line/Realtime product, PPTN will need to complete forms located at: http://www.wheatlandsadmin.com/part_B/edi/agree.htm. Two forms must be completed and faxed to 785-290-0770.
    • Access to Medicare On-Line/Realtime applications for Medicare A (FISS) and Medicare B (PPTN) must go through a Network Service Vendor.
  • CMS expects to announce the new contractor for Jurisdiction 5, Kansas, Nebraska, Missouri and Iowa, by the end of July. In preparation of this move vendors may want to have clients begin splitting Medicare claims and other payer claims into separate batches.

NPI:

  • A review of payer NPI status. We encourage all clients and business partners to begin submitting the NPI along with the legacy billing provider number. Please review each payers NPI plan.
  • Payers, including Blue Cross and Blue Shield of Kansas, Kansas Medicare A, and Medicare B for Kansas, Nebraska, and NW Missouri, are contacting providers urging the submission of NPI only or Legacy and NPI billing provider, reviewing editing and adjudication of claims.
  • Warning and reject messages are being reported back on payer electronic transaction reports. Payers are urging providers who are not receiving this valuable tool to contact the vendor, clearinghouse, or billing service they are business partners with and have this reporting provided to them.
  • We urge you and your clients to contact EDI at 1-800-472-6481 for assistance.  

Trading Partner Education:

  • ASK and Blue Cross Blue Shield of Kansas will continue to contact providers regarding errors with NPI.  
  • Medicare continues to contact providers by phone, submitting one claim without an NPI. Medicare generates calls based on the week before claim submission, Saturday through Friday.

 

System Updates:

  • An EDI system deployment is scheduled for August 5, 2007.  
  • Medicare A ONLY, will implement two new NPI warnings and two new NPI rejection edits. 

 

Edit Code

Message

Logic

837I

M372 Warning

Billing NPI not tied to TP number

Legacy and NPI submitted.
Billing NPI submitted in the 2010AA NM109 is not tied to TP on EDI Front End

837I

M373 Warning

EDI Authentication Failed

Legacy and NPI submitted.
Billing NPI submitted in the 2010AA NM109 fails authentication of version (004010X096A1) and/or  payer id (00150) and/or test or production indicator (T/P)

837I

M372A Reject

Billing NPI not tied to TP number

NPI Only submitted. 
Billing NPI submitted in the 2010AA NM109 is not tied to TP on EDI Front End

837I

M373A Reject

EDI Authentication Failed

NIP Only submitted.
Billing NPI submitted in the 2010AA NM109 fails authentication of version (004010X096A1) and/or payer id (00150) and/or test or production indicator (T/P)

Upcoming events:

  • EDI Workshops

August 8, 2007 – Pratt, KS

We want to encourage you and your clients to share suggestions and ideas on how EDI Services can provide better assistance.  Please send emails to askedi@ask-edi.com or MedicareEDI@wheatlandsadmin.com with suggestions. 

The next regularly scheduled conference call is August 16, 2007.
Phone Number: 1-877-326-2337 – Pass code 2102557

Web Addresses:
www.wheatlandsadmin.com
www.ask-edi.com
www.bcbsks.com
www.bcbskc.com

Email Address:
askedi@ask-edi.com                          
MedicareEDI@wheatlandsadmin.com

Phone: 800-472-6481

 


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