Vendor Meetings
Blue Cross Blue Shield of Kansas EDI Services
Vendor Call Minutes
June 17, 2010
ANSI 5010:
- Timelines:
- Timelines will soon be updated on the ASK and BCBSKS websites.
- BCBSKS – Testing 10/01/2010 – Production 02/01/2011
- BCBSKC – Testing 01/01/2011 – Production 05/2011
- Notable Changes in 5010:
- 5010 837 Dental transactions now allow for the submission of diagnosis codes. In the past some dental surgeries have needed to be filed as 837P. This change will allow these charges to be filed as 837D. Check with the payer for requirements.
- Tax ID numbers are still required on all claims along with the NPI. Secondary identification numbers, such as legacy payer ID's are not allowed in conjunction with the NPI. Claims submitted using both the NPI and legacy numbers will be rejected.
- 5010 provides standard formatting instructions for critical fields, such as the SSN and Telephone Numbers. In these cases dashes, hyphens or spaces will not be allowed.
- The number of patient relationship codes has been reduced to allow only those with clearly differentiated meanings.
- Example: the current ANSI 4010A1 lists separate codes for child, adopted child, foster child, stepson, and stepdaughter. ANSI 5010 has only one code for child.
- A Service Facility loop should only be submitted if it is different than the Billing Provider loop.
- Billing Provider and Service Facility will now require the submission of zip + 4.
- Billing Provider Address cannot contain a P.O. Box.
- The 277 Claims Acknowledgement (CA) is not a required transaction, however; the only acknowledgement provided by Medicare is the 277CA. ASK will give each trading partner the option to receive either the 277CA or a modified legacy report.
- 277CA is an ANSI transaction and will not be provided in a readable format. Trading partners will need a mechanism to create a readable format.
- ASK legacy reports will be changing with 5010.
- EDI will be referring trading partners to their vendor or clearinghouse for assistance.
- The 277CA Code Source is located at: http://www.wpc-edi.com/content/view/711/401/
- ASK Changes with 5010:
- In preparation for 5010, ASK will continue to work on updating the ASK website. Trading partners will be required to select the ANSI version before entering the secure section for each file transfer. As a reminder a different address will also be used for Secure FTP and trading partners will use a different user name and password for each version.
- Files will need to be split by payer at the GS-GE. This means there will be separate GS – GE loops for BCBSKC, BCBSKS, PHP, EDI Midwest and HealthNow NY. All EDI Midwest payers can be submitted within one GS-GE.
During the call there was some discussion about multiple GS-GE loops within a single ISA-IEA. Research shows that multiple GS-GE loops are allowed. In the TR3 on page B.2, the Transmission Control Schematic is presented showing more than one GS-GE loop for an ISA-IEA. If you have further questions regarding this, please feel free to contact us.
- With the separation of files for each payer, payer identification will be required in the GS03. The following are the accepted values for this field:
- BCBSKS
- BCBSKC
- PHP
- EDIM
- HNNY
- The Claims Confirmation Report presented today will be redesigned for 5010. An example of new legacy report, EDI Response Report, will be posted to the ASK Website as soon as it is available. The new format will be provided in a text format however; the error codes listed in the report will be the same provided in the 277CA. ASK will give each trading partner the option to receive either the legacy report or the 277CA.
- ASK is making a last effort to contact software vendors with questions about their HIPAA 5010 implementation plans. If you have not received an email, please contact us at 1-800-472-6481, option 3. Contact information will be verified and will be used for contacting vendors during the 5010 migration.
- Vendors are encouraged to sign up for the HIPAA 5010 email notifiers available on the ASK and BCBSKS websites. This is the best way to stay current on payer timelines and any information related to HIPAA 5010.
System Updates
- The next system deployment is scheduled for September 19, 2010
Telecommunication Update
- Dial up FTP will be not be available for trading partners submitting HIPAA 5010.
Upcoming events
EDI Marketing Representatives are available to attend provider 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 July 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.bluekc.com Phone: 800-472-6481
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