ABILITY | PC-ACE ™:
Due to the Health Insurance Portability and Accountability Act (HIPAA), change request 9666, and electronic data interchange (EDI) front-end updates, the Centers for Medicare & Medicaid Services has implemented 5010 837P and 837I transaction edits, effective January 1, 2017. [CR 9666]
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.
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.
The Centers for Medicare & Medicaid Services (CMS) recently released change request (CR) 9906, which revises Chapters 12, 17, and 23 of the Medicare Claims Processing Manual to ensure that all remittance advice coding is consistent with national standard operating rules. [MM9906]
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) 9878 which updates the remittance advice remark code (RARC) and claim adjustment reason code (CARC) lists. CR 9878 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 July 3, 2017. [MM9878]
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]
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.
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]
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