Vendor Meetings
Blue Cross Blue Shield of Kansas EDI Services
Vendor Call Minutes
August 16, 2007
General Announcements:
- On July 31, 2007, CMS was to have announced the new contractor for Jurisdiction 5, which includes Kansas, Nebraska, Missouri and Iowa. CMS has determined it will be the end of August before the winner of the bid will be announced. In preparation of this move Trading Partners are encouraged to begin splitting Medicare claims from all other payers. This will become a requirement at sometime in the near future when Medicare claims will be submitted to the new carrier and we would like to make this transition as smooth as possible.
NPI:
- BCBSKS:
- 837 Transactions (Claims) – Accepts NPI only, Dual Use, or Legacy only. Trading partners wanting to send NPI only must notify BCBSKS first.
- 835 Transactions (Remits) – Trading partners will receive the same provider numbers submitted on the claims.
- BCBSKC:
- 837 Transactions (Claims) – Accepts NPI only, Dual Use, or Legacy only.
- 835 Transactions (Remits) – Trading partners will receive both legacy and NPI on all 835 transactions, if the NPI has been reported to BCBSKC.
- Medicare A:
- 837 Transactions (Claims) – Accepts NPI only, Dual Use, or Legacy only.
- Medicare B:
- 837 Transactions (Claims) – Accepts NPI only, Dual Use, or Legacy only.
- Effective August 25, 2007, Wheatlands Administrative Services Part B, will begin editing the NPI/legacy ID combinations for validity against the NPI crosswalk file. Where a match cannot be located on the crosswalk, claims will be rejected or returned to the provider. August 24, 2007 Medicare B will update current NPI informational edits to rejections. The effected edits are:
- M340 (2010AA Billing Provider NPI/PIN Validation Edit)
- M341 (2010AB Pay To Provider NPI/PIN Validation Edit)
- M343 (2310B Rendering Provider NPI/PIN Validation Edit)
- M347 (2420A Rendering Provider NPI/PIN Validation Edit)
- M379 (2010AA Billing Provider NPI/TIN Validation Edit)
- M380 (2010AB Pay To Provider NPI/TIN Validation Edit)
- M381 (2310B Rendering Provider NPI/TIN Validation Edit)
- M382 (2420A Rendering Provider NPI/TIN Validation Edit)
Additional information on the topic can be found at http://www.kansasmedicare.com/part_B/npi/LiftingTheNPICrosswalkBypassLogic_000.htm
- The following MedLearn Matters publication gives instructions for submitting NPI.
- EDI is available to assist you and your clients with NPI. Please contact us at 1.800.472.6481
- BCBSKS, and Medicare A and B are urging the submission of NPI only.
- CMS has announced the dissemination list concerning all NPI's to be published September 4, 2007. Information was posted on the BCBSKS website as well as Medicare:
Trading Partner Education
- ASK and BCBSKS are continuing to contact providers regarding errors with NPI. This is being done to ensure a smooth transition for NPI. Documentation of all calls will be maintained to assist with any questions regarding the calls.
- Medicare A and B have also been contacting providers submitting claims without the NPI. Telephone calls have been made and letters have been sent. The calls and letters are to encourage providers to begin sending NPI as soon as possible. The EDI Department does not have documentation on the problems generating the calls, but if questions arise, we will be glad to look at current files to determine how the file is received.
- Warning and Rejection messages are reported back to the trading partner on several reports. It is important that all reports are reviewed for Warnings and Rejections. Warnings will not cause the claims to reject; however, they should be corrected as soon as possible to avoid rejections in the future. The EDI Help Desk will be glad to help with any questions regarding the edits. Warning and rejection edits can be found on the Claims Confirmation Report, MCS EDI Edit Reports (IXE extension), and the EDI Midwest Reports.
System Updates:
- The next routine system deployment is scheduled for September 30, 2007.
Remits:
- Due to a data center issue, a delay was experienced in the receipt and distribution of Medicare B 835 remittance advices with a date of August 6, 2007. Remittance advices dated August 6, 2007, were distributed to trading partner mailboxes on Friday, August 10th after 3:00 p.m. Some trading partners may have received a duplicate of the August 6th remittance advice on August 13, 2007.
Upcoming events:
- Blue Cross and Blue Shield of Kansas offices will be closed on Monday, September 3, 2007, in observance of the Labor Day holiday.
- EDI Workshops
September 13, 2007 – Hays, KS
September 13, 2007 – Overland Park, KS
Provider Communications:
- On August 10, 2007, BCBSKS issued a publication providing additional information on NPI's.
http://www.bcbsks.com/providers/npi/news.htm.
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 September 20, 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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