ABILITY | PC-ACE ™:
Medicare EDI Trading Partners are required to use a Network Service Vendor (NSV) for connectivity to the EDI Gateway
Effective March 2, 2015, all Medicare EDI Trading Partners submissions and retrievals are required to use a Network Service Vendor (NSV) for connectivity to the EDI Gateway.
Due to the Health Insurance Portability and Accountability Act (HIPAA), change request 9881, and electronic data interchange (EDI) front-end updates, the Centers for Medicare & Medicaid Services has implemented 5010 837P and 837I transaction edits, effective July 1, 2017. [CR 9881]
Affordable Care Act - Operating Rules - Requirements for Phase II and Phase III Compliance for Batch Processing
The Centers for Medicare & Medicaid Services (CMS) is in the process of implementing operating rules adopted under Section 1104 of the Affordable Care Act.
To improve claims processing and improve readability success rates with its optical character recognition (OCR) systems, First Coast Service Options Inc. (First Coast) has redesigned its PWK fax and mail cover forms for providers who submit unsolicited additional documentation with their claims.
Guidance with outpatient facility claims and entering claims via DDE screens to reduce claims not crossing over
This article assists billing offices in correctly submitting institutional claims on incoming 837 outpatient facility claims as well as direct data entry (DDE) claims. Effective August 7, 2017, two return-to-provider (RTP) edits will be enforced. [SE17015]
First Coast's claims department and providers are being negatively impacted by a high volume of invalid or unnecessary PWK fax/mail coversheets. This article reviews information on how you can avoid these issues. [CR 7330]
First Coast Service Options Inc. (First Coast) has implemented the PWK (paperwork) segment of the X12N version 5010. This allows for submission of supporting documentation with a version 5010 electronic claim. [CR 7330]
The Centers for Medicare & Medicaid Services (CMS) updates the claim adjustment reason codes (CARC) and remittance advice remark codes (RARC) rule, which includes the claim adjustment group codes (CAGC). [MM10041]
CMS releases remittance advice remark code, claims adjustment reason code, Medicare Remit Easy Print and PC Print updates
The Centers for Medicare & Medicaid Services (CMS) recently released change request (CR) 10040, which updates the remittance advice remark code (RARC) and claim adjustment reason code (CARC) lists. CR 10040 also calls for an update to Medicare Remit Easy Print (MREP) and PC Print software. If you use MREP or PC Print software, be sure to obtain the latest version that is released on or before October 2, 2017. [MM10040]
Following the June meeting of the National Code Maintenance Committee, the Centers for Medicare & Medicaid Services (CMS) will update Medicare claim status category codes and claim status codes. [MM10043]
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.