Vendor Meetings
Blue Cross Blue Shield of Kansas EDI Services
Vendor Call Minutes
August 18, 2005
Today’s vendor call was dedicated to the Medicare B Multi-Carrier System (MCS) transition.
The Medicare B Multi-Carrier System (MCS) Implementation is scheduled for September 6, 2005.
- Updates are continually posted to the MCS section for the Medicare Website. All vendors and their clients are encouraged to sign-up for the E-mail List Sign-up.
- Customer Service will not be available during the MCS “dark days” on September 1 and 2, 2005.
- EMS Help Desk will be available for electronic transaction questions throughout the transition.
MCS Claim Submission Tips have been added to the Medicare Website. The top reasons for claim rejection during the testing faze of MCS were reviewed in the meeting. (http://www.kansasmedicare.com/part_b/mcs/claim_submission_tips.htm)
- Physician Signature Requirement for Electronically Submitted Claims : The Physicians Signature information must be submitted in the 2300 CLM06 loop and segment. Allowed values are a "Y" or an "N". We are seeing numerous claims being submitted with a value of "N". Once we convert to the MCS system these claims will be rejected as unprocessable. The Physician's signature is required. Please ensure that you are using the correct value for your claim submission; a "Y" if the Physician's signature is on file or “N” if not.
- Beneficiary Signature Information for Electronic Claims 7/28/05 : The Beneficiary Signature information must be submitted in the 2300 CLM09 and CLM10. The 2300 CLM10 is required to be completed except when the CLM09 is equal to N. This is a correction of the information previously provided in the MCS workshops. We apologize for this error. This change can be made prior to the conversion to MCS. If this information is not completed the claim will reject as unprocessable in the MCS system.
- Service Facility Location for Electronically Submitted Claims : You must provide the service facility location (Facility Provider Name, street address, city, state and zip code) if the service facility location is not the same as the billing provider location or the pay-to provider location. This should be reported in either the 2310D or 2420C Loop - Service Facility Location. If there are different service facility locations being reported on the same claim, then the Facility Provider Name, street address, city, state and zip code for the different locations would need to be reported at the 2420C Loop. This change can be made prior to the conversion to MCS. If this information is not completed the claim will reject as unprocessable, MA130 in the MCS system.
- Laboratory Services Referred to Another Laboratory Covered by the CLIA Act : Claims for clinical laboratory services, which were referred to another laboratory (covered by CLIA), must contain the modifier 90 on the laboratory charge service line. The modifier must be entered in one of the modifier fields (2400-SV101-3 through 6). The claim also must contain the referral laboratory Facility Certification Number (CLIA number), with and “F4” qualifier at the 2400-REF segment for the service line for which laboratory charges are being billed.
- Chiropractic claims require an Initial Treatment Date for spinal manipulations . When submitting this information electronically, this date is required at the 2300-DTP segment with a qualifier of '454' in the 2300-DTP01 to indicate 'Initial Treatment Date' for the entire claim. If a claim has multiple service lines and it is necessary to report a date that is different than the date reported in the 2300 loop (claim level), the different 'Initial Treatment Date' would need to be placed in the 2400-DTP segment for that service line. The qualifier in the 2400-DTP01 would also need to be '454' to indicate the 'Initial Treatment Date'.
PC-ACE Pro32 (free billing software)
- Updates have been added to the Medicare Website showing providers how to submit MSP claims using the PC-ACE Pro32 Software. (http://www.kansasmedicare.com/part_b/edi/pdf/basic_claim_info_msp.pdf)
Medicare Secondary Payer (MSP):
- Tips for filing Medicare Secondary Payer (MSP) claims electronic have been added to the Medicare Website. (http://www.kansasmedicare.com/part_b/edi/pdf/Required_Loops_Segments_MSP_tips.pdf)
Answers to questions from vendors:
- The last day for claims processing in VMS will be August 26, 2005.
- Trading Partners/Providers should submit claims on their regular schedule during the transition. Please do not hold claims in your offices.
- All MSP claims should be filed electronic. If clients are not receiving the correct reason codes required for the CAS segment of the electronic claim, they will need to contact the primary payer sending the remit and request the HIPAA compliant codes. Medicare will only accept valid HIPAA compliant codes.
- The Medicare Claims Contingency Plan is scheduled to end on October 1, 2005.
- Reports generated by the EDI Services system are not changing and will continue to be available in the Trading Partner mailboxes throughout the MCS Transition. Medicare B claims received by EDI Services after 5:00 P.M. on August 26, 2005 will not receive reports from the MCS Front End Processing System until the transition is completed.
- All claims should be submitted electronic. If additional information is needed to process the claims, Medicare B will send a letter requesting additional information.
- The MCS Transition affects Medicare Part B only.
- Wyandotte and Johnson Counties in Kansas should have the payer id changed to 00650 for any claims submitted after 5:00 P.M. on August 26, 2005. Provider numbers will not change. Claims received with the incorrect payer id will receive the error code M010 “ Billing Number not on payer provider file”.
Other Announcements:
- 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.
The next regularly scheduled conference call is September 15, 2005.
Phone Number: 1-877-326-2337 – Pass code 2102557
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