Vendor Meetings

Blue Cross Blue Shield of Kansas EDI Services
Vendor Call Minutes
October 18, 2007

General Announcements

• Blue Cross and Blue Shield of Kansas (BCBSKS) and Wisconsin Physicians Services (WPS) are currently working for a smooth transition for the Medicare Part A and B transition to Jurisdiction 5.  This will include the transition of Medicare Part A for Kansas, and Medicare Part B for Kansas, Nebraska and NW Missouri to be completed on March 1, 2008.  To keep current on transition activities, vendors and trading partners are encouraged to sign up for email notification.  As information becomes available it will be posted at http://www.wheatlandsadmin.com/WPSJ5Contractor.htm.
• More information on Medicare Reform can be found at http://www.cms.hhs.gov/MedicareContractingReform/01_Overview.asp#TopOfPage. 
• A direct link to the Medicare WPS website with information regarding the transition is http://www.wpsmedicare.com/provider/mac.shtml.

NPI Information

• BCBSKS:
• 837 Transactions (Claims) – Accepts NPI only, Dual Use, or Legacy only.  Trading partners wanting to send NPI only must notify BCBSKS first.
• NPI will be required on all claims submitted January 1, 2008 or later.
• A new edit will be added on December 3, 2007, to replace the E010A edit currently in place.  This edit will be a warning until January 1, 2008, when claims will begin to reject requiring an NPI.
• 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.
• NPI will be required on all claims submitted January 1, 2008 or later.

Claims submitted with legacy only will be returned to the providers on remits as unprocessable, MA130.  Providers were notified of this change through
http://www.wheatlandsadmin.com/part_a/npi/MedicarePartANPIRequiredJanuary12008.htm.

• Medicare B:
• 837 Transactions (Claims) – Accepts NPI only, Dual Use, or Legacy only.
• October 15, 2007 Medicare B began returning new informational edits.
• M389    2010AA NM108   Billing Provider Identification Code Qualifier Invalid value.  The edit sets when the 2010AA loop and NM1 are submitted but NM108 does not contain XX.
• M390    2010AB NM108   Billing Provider Identification Code Qualifier Invalid value.  The edit sets when the 2010AB loop and NM1 are submitted but NM108 does not contain XX.
• M391    2310B NM108   Claim Level Rendering Provider Identification Code Qualifier Invalid value.  The edit sets when the 2310B loop and NM1 are submitted but NM108 does not contain XX.
• M392    2420A   NM108   Detail Level Rendering Provider Identification Code Qualifier Invalid value.  The edit sets when the 2420A loop and NM1 are submitted but NM108 does not contain XX.
• Notification was posted at:
  http://www.wheatlandsadmin.com/part_B/edi/MCSEdits10152007.htm

• MCS EDI Edit logic is posted at:
  http://www.wheatlandsadmin.com/part_B/edi/documents/EditList712007.pdf
• If providers have questions concerning validating NPI numbers being submitted instruction is posted at: http://www.wheatlandsadmin.com/part_a/npi/MedicarePartANPIInformationWhattodoifclaimsarerejected.htm and
  http://www.wheatlandsadmin.com/part_b/ClaimsAreReturnedBecauseTheNPIDoesNotMatch.htm
• Providers can contact Medicare Provider Call Center at 1-877-567-7270 for any additional questions they have.  

• 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.
• The NPI Registry is now available and can be found at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do.

Trading Partner Education

• 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.

All Payer Information

• BCBSKC
• 835 Remits delivered on 10/16/2007 were duplicates of remits sent on 9/4/2007.  BCBSKC is aware of the problem and will generate the correct file to be posted by no later than Friday, October 19, 2007.

Telecommunications Changes

•  ASK is currently working to provide multiple file downloads through the ASK website.  A date for the completion of this project will be announced later.

System Updates

• The next routine system deployment is scheduled for December 2, 2007.

Upcoming events:

• EDI Workshops

November 1, 2007 – Independence, MO

• Conventions

October 26, 2007 – KCA – Topeka, KS
November 14 & 15, 2007 – KHA – Wichita, 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 November 15, 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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