Vendor Meetings
Blue Cross Blue Shield of Kansas EDI Services
Vendor Call Minutes
July 21, 2005
CMS is reporting the National Percentage for migration to the HIPPA formats at 99.52%. ASK is reporting 100% of the Submitters and 100% of the claims volume are received in the HIPAA format, ANSI 4010A1. Some Trading Partners are still receiving the proprietary format for Medicare Remits.
General Announcements:
- July 26, 2005 notification was received. A postponement of the Medicare B Multi-Carrier System (MCS) Implementation is emanate.
- Plan 65 payments and BCBSKS payments will no longer be split into separate remits. Plan 65 payments will be posted on the BCBSKS remits. This change is effective upon implementation of the Medicare B MCS Transition. Letters were mailed July 21 prior to the MCS announcement.
Upcoming Events
- The next EDI System deployment is scheduled for July 31, 2005.
MCS Transition:
- Due to the MCS announcement the payer ID change for Johnson and Wyandotte Counties in Kansas that was schedule for July 26, 2005 was postponed. Providers, Vendors, and Trading Partners in these counties will receive notification as to the new dates by mail.
- MCS Workshops for provider education have been held in Kansas, NW Missouri and Nebraska. The final workshops were held on Friday, July 22. Issues discussed at the workshops include:
- Claims submitted to the MCS system will need to make sure they provide the rendering provider number and the group provider numbers in the correct locations, or claims will be returned as unprocessable. This is primary a problem for providers submitting on paper. Paper submitters will need to make sure the individual provider number is listed in box 24k (Loop 2310B REF02) and the group or solo practitioner number is listed in box 33 (Loop 2010AA REF02).
- Paper claim submitters will only be allowed to submit one diagnosis pointer per line item.
- Claims requiring CLIA numbers and mammography numbers will need to be split into separate claims. (Electronic and Paper)
- CR3440 stated that beginning July 1, 2005, all claim types must be filed electronically unless the provider falls within the guidelines for exemption. This includes Medicare Secondary claims (MSP).
- The sample of the new Medicare B MCS Front-End Edit Report is now available for vendor testing. Instructions to download the report can be found on the Medicare website.
- MCS Edits related to the Medicare B MCS Front-End Edit Report will be posted to the Medicare Website.
- An Emergency MCS Vendor call was held on July 26, 2005.
- Topics included
- Johnson and Wyandotte counties of Kansas providers will need to change the payer ID. This is postponed along with the MCS Transition.
- Service Facility Location must be submitted as instructed in the Medicare Communiqué posted at http://www.kansasmedicare.com/part_B/News/Physician/2003_12/communique_dec03.pdf. If this is not submitted in the MCS system the claims will be returned with a MA130 as unprocessable.
- Physicians Signature 2300 CLM06 must be submitted.
- Beneficiary Signature 2300 CLM09 and CLM10 must be submitted.
- Medicare Payment Floors were reinstated to 14 days for electronically submitted claims and 27 days for paper submitted claims.
835 Information:
- Remits will be returned to the provider with the NPI number if the NPI number is submitted on the claim.
- Kansas City is periodically having problems creating 835’s. Once their system thinks it has created an 835, they cannot create a second 835, so providers may have to rely on the paper remit for hand posting. BCBSKC is working on the problem.
- Reminder: When moving from Test to Production there is a possibility of partial or no Test or Production remittance advice being created for the date movement from Test to Production.
- Providers previously set to production for 835 transactions are beginning to receive notification from Medicare A that their paper remits will be terminated on July 5. Providers need to contact the telephone number listed in the letter for any questions.
- Beginning July 1, 2005, providers adding 835 transactions for Medicare A, will only receive the paper remittance for 31 days after production status is reach.
- As of June 1, 2005, PC Print was made available for download on the Medicare A web site http://www.kansasmedicare.com/part_A/edi/free.htm, supplying the Trading Partner with a mechanism for print image of the 835 remittance advice. This software does not post remittance advices. PC Ace Pro 32 software is also available for print image.
Telecommunications Changes:
- ASK will be discontinuing the dial-up connections for file transfer. Vendors should encourage their sites to move to IVANS, VisionShare, or using the ASK Website. This does not affect calls to Customer Service, the Help Desk, connections through the Internet, vendors, or clearinghouses. FTP Dial-up has not yet been scheduled for this change.
- Toll-Free dial-up access for file transfer will be discontinued on September 1, 2005. Trading Partners still using the dial-up option after September 1 will need to change the phone number to 785-291-0278.
- All additional dial-up access for file transfer is tentatively scheduled for disconnection in April 2005.
- A worksheet to help providers determine future needs will be posted to the Websites for ASK, Medicare and BCBSKS. Providers should use this worksheet before contacting IVANS or VisionShare.
270/271 Issues:
- Blue Cross and Blue Shield of Kansas is ready for production.
- BCBSKS is currently testing 270/271 Real Time over the Internet.
- Blue Cross and Blue Shield of Kansas City expects to be ready for production by early August.
276/277 Issues:
- Medicare A and B are currently working with test beta sites. Testing has identified some issues. Nothing new to report.
- Blue Cross and Blue Shield of Kansas. Currently on production.
- Blue Cross and Blue Shield of Kansas City expects to be ready for production by early August.
The next regularly scheduled conference call is 08/18/2005.
Phone Number: 1-877-326-2337 – Pass code 2102557
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