Vendor Meetings

Blue Cross Blue Shield of Kansas EDI Services
Vendor Call Minutes
March 18, 2010

General Information:

• ANSI 5010:  We reviewed the HIPAA Version 5010 dates and what each level of compliance means:
• By December 31, 2010 all covered entities must achieve Level 1 Compliance.
  Level 1compliance = All covered entities must have all internal testing complete. All must be able to receive and send a HIPAA 5010 compliant transaction.
• By January 1, 2011 Level 2 testing period begins.
  Level 2 testing = Trading Partners can begin HIPAA 5010 testing and move toward the production date of January 1, 2012. 
• By January 1, 2012 Trading Partners and covered entities must achieve Level 2 compliance.
  Level 2 compliance – Only version HIPAA 5010 can be used.
• Update in terminology for the ANSI 5010 implementation guides. Implementation Guide is now referred to as TR3's (Technical Reports).  These may be purchased through the Washington Publishing Company. 
• Upcoming Just ASK Newsletter will contain HIPAA 5010 information.      
• ASK Changes with 5010:
• The Claims confirmation Report will be redesigned with 5010.  A system generated example of the new redesign will be posted as soon as it is available.  The new format will continue to be provided in a text format and the error codes listed in the report will be the same as those used on 277CA.
• Trading partners using the ASK website file transfer will need to select options for 4010A1 or 5010.  Secure FTP users will also be sending to a different address for 5010.
• Files will need to be split by payer at the GS-GE.  This means there will be a separate GS-GE for BCBSKC, BCBSKS, PHP, and EDI Midwest.  All EDI Midwest payers can be in the same GS-GE. 
• Some type of payer identification will be needed in the GS03 (Application Receiver's Code).  Our team as considered using either a payer ID or an acronym that identifies the payer, such as '47163' or 'BCBSKS' for Blue Cross and Blue Shield of Kansas. 
• Discussion on this topic indicated that some vendors do not like this change and will probably have to send separate files.  Another vendor indicated this may cause problems posting 835 transactions back to the correct 837 if the GS is different for the 835.  Lori indicated she would take these comments back to the team for further review.
• Remit file names will no longer designate either test or production.
• Noticeable Changes in 5010:
• Information provided in the billing provider loop will be used as the service facility and the service facility should only be included if it is different from the billing provider.  Because of this, the following changes have been made in HIPAA 5010.
• Billing Provider and Service Facility will now require a 9 digit zip code, or the zip + 4.
• Billing Provider Address must contain a physical address.  This means a P.O. Box will not be allowed.
• Secondary Identification Numbers, such as legacy numbers assigned by the payer, are not allowed in conjunction with an NPI.  Tax ID numbers are still required on all claims in the appropriate field.
• 277CA Reports – This is a "business level acknowledgement for the ASC X12 Health Care Claims (837)…"  The 277CA will identify both accepted and rejected claims. 
• During the call some vendors indicated they would prefer to have the Claims Confirmation Report.  All trading partners will be given the choice to receive either the redesigned Claims Confirmation Report or the 277CA. 
• The only claims confirmation provided by Medicare with 5010 will be through the 277CA.
• Concerns with 5010:
• Providers will need to remember to notify the payer and ASK if they get new NPI's.
• Providers are delaying education for 5010 and believe their software vendors will 'take care of it'.
• Providers will not know how to read the 277CA if their software vendors do not provide a readable version.
• There are no more contingencies expected from CMS.  CMS has already provided a contingency from 4/2010 and ICD-10 is dependent on the implementation of 5010.
• ASK is in the processes of contacting all vendors.  A small group of emails were sent to several vendors requesting information regarding their deployment plans, reports, and updates to contact information.  Nearly 1/3 of the emails sent were returned for bad email addresses emphasizing the need to update contact information.  ASK will use this information to provide information to vendors and it is vital to have the information current.  Please remember to respond to the emails when you receive them.     

System Updates

• The next routine system deployment is scheduled for March 21, 2010.   

Telecommunication Update

• Dial up FTP will be eliminated with HIPAA 5010 implementation.

Upcoming events

• GKCMMA 20th Annual Education conference
  Dates:  March 24, 2010
  Venue:  Ritz Charles Conference Center, Overland Park, KS
• KPTA Spring 2010 Conference and Tradeshow
  Dates: April 9 – 11, 2010
  Venue: Hilton Wichita Airport Executive Conference Center, Wichita, KS
• 2010 EDI Workshops and the 2010 Trade Show Calendar are posted at: 
  http://www.ask-edi.com/events.htm.
• Our EDI Marketing Reps are available for provider community events. Please contact us today at 1-800-472-6481 option number 3, if you and your clients have an event you would like us to attend.

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 with suggestions. 

The next regularly scheduled conference call is April 15, 2010.
Phone Number: 1-877-326-2337 – Pass code 2102557

Web Addresses:                                                         Email Addresses:
www.ask-edi.com                                                       askedi@ask-edi.com  
www.bcbsks.com
www.bcbskc.com                                                       Phone: 800-472-6481

 

 

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