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Please use this area to access the most current, up-to-date information on electronic carriers through Proxy Med. Make note that this page may contain information that does not apply to your situation. For questions regarding this page, or electronic services, please send an e-mail correspondence.
Saturday, July 31, 2004
CareSource
The following broadcast was sent out from ProxyMed. Please make sure that if you
have customers submitting to CareSource, that they are following the
instructions below. If they fail to send in the information to NDCHealth, they
will not be able to submit claims electronically to CareSource.
Registration is now required for CareSource. In order to submit your
claims electronically we will need you to register your CareSource Provider ID
number with us.
The CareSource Provider ID is nine (9) digits (all numeric) and is not the
Provider/Practice Tax Identification Number. If you are not sure what your
CareSource Provider ID number is, please contact the Service Center at
CareSource 1-800-488-0134.
Please fax the CareSource Provider ID to NDCHealth EDI Registration at
480-635-8271. The information should be on company letterhead. Please include
the following on the letter:
•Practice Name
•Provider Name
•Tax ID
•CareSource Provider ID
•Clearly state that you are registering your CareSource Provider ID.
Thursday, July 22, 2004
NY GHI Medicare (00004) – Reject for
referring provider ID
A problem has been reported by GHI Medicare providers when sending claims that
contain referring provider information. It appears that there is a problem with
the referring provider UPIN as it gets mapped into the ANSI 837 claim format.
Customers with this problem will get this message on their delayed response
reports “REJECTED AT PROXYMED REFERRING PROVIDER ID INVALID (MR045) ( ) . You
will receive an EDI Alert notifying you when the problem has been corrected.
Wednesday, July 21, 2004
Oklahoma Medicare (00149) – Claims Resubmitted
Claims transmitted from the clearinghouse to Oklahoma Medicare from June 25th to
July 19th were not processed due to a problem with the billing provider number.
The problem has been corrected and all affected claims were retransmitted to the
payer on July 20th. Customers did not receive rejections in their delayed
response reports because the number was invalid and reports could therefore not
be parsed back to the customers’ mailboxes.
Florida Medicare (00118) – Claims Resubmitted
Florida Medicare claims which were transmitted on 6/4 - 6/7, 6/17, 6/21 and 6/29
were transmitted to FCSO with an invalid sender number. The claims were
retransmitted with the correct number on July 8th. Steps are being taken to
prevent this from happening again in the future. We apologize for any difficulty
this has caused.
Thursday, May 20, 2004
New BCBS Policy Format for
North Carolina
The Spring 2004 edition of NC BCBS’s BlueLink
newsletter stated that they would be assigning new policy numbers that were not
derived from the member’s social security number. The article stated that the
transition would begin in February 2005. This change was reported to ProxyMed,
so that the policy number edit could be changed in time for the February 2005
implementation. It has been found, however, that there are some national
accounts, such as Kinko’s which have plan offices in North Carolina. We have
asked ProxyMed to relax the policy number edit as soon as possible in order to
accommodate these other plans. Please check future EDI Alerts for more
information in the near future.
Tuesday, May 11, 2004
Tennessee Medicare Alert
Proxymed is scheduled to migrate Tennessee Medicare to the ANSI 4010A1 format on
6/4/04. Re-enrollment is required for all providers who will be continuing to
send claims electronically to this payer. Proxymed mailed out a letter regarding
re-enrollment to all providers that have transmitted to Tennessee Medicare in
the last 3 months. The letter includes the Medicare Part B EDI Customer Profile
and the Proxymed Agreement Tracking Form. Providers need to complete the EDI
Customer Profile and mail directly to the carrier. The Agreement Tracking Form
needs to be completed and faxed back to Proxymed. If you have customers who call
you regarding this letter, please encourage them to complete the appropriate
forms as quickly as possible. It may be a good idea to check with your customers
to see if they received the letter. An electronic copy will be posted to the
carrier agreement map later this week for those who did not receive one directly
from Proxymed.
Tuesday, May 11, 2004
Tennessee Medicare Alert
Proxymed is scheduled to migrate Tennessee Medicare to the ANSI 4010A1 format on
6/4/04. Re-enrollment is required for all providers who will be continuing to
send claims electronically to this payer. Proxymed mailed out a letter regarding
re-enrollment to all providers that have transmitted to Tennessee Medicare in
the last 3 months. The letter includes the Medicare Part B EDI Customer Profile
and the Proxymed Agreement Tracking Form. Providers need to complete the EDI
Customer Profile and mail directly to the carrier. The Agreement Tracking Form
needs to be completed and faxed back to Proxymed. If you have customers who call
you regarding this letter, please encourage them to complete the appropriate
forms as quickly as possible. It may be a good idea to check with your customers
to see if they received the letter. An electronic copy will be posted to the
carrier agreement map later this week for those who did not receive one directly
from Proxymed.
The following payers are not accepting new enrollments at this time due to pending ANSI 4010A1 approval.
| Payer ID | State | Payer Name | ETA for ANSI Conversion |
| 1/5 | NY | Empire Medicare | 3/12/2004 |
| 2/15 | NJ | Medicaid | 3/26/2004 |
| 4/20 | AR | Medicare | 3/5/2004 |
| 4/23 | CO | Medicare | 4-Mar |
| 5/3 | IA | Medicare | 3/12/2004 |
| 145 | NY | Upstate Medicare | 4-Apr |
| 166 | AZ | Medicare | 3/12/2004 |
| 167 | ID | Medicare | 3/26/2004 |
| 171 | NV | Medicare | 4/2/2004 |
| 172 | OR | Medicare | 4/2/2004 |
| 174 | AK | Medicare | 4/2/2004 |
| 520 | AR | BCBS | 3/26/2004 |
| 803 | NY | Empire BCBS | 3/26/2004 |
| 866 | PA | BCBS | 4/23/2004 |
Friday, February 27, 2004
The following claims are now being transmitted from ProxyMed in the ANSI 837 4010a1 format:
Amerigroup
Blue Cross/Blue Shield of Arizona
Delaware Medicare Part B
Georgia Medicare Part B
Maryland Medicare Part B
Texas Medicare Part B
Virginia Medicare Part B
Washington D.C. Medicare Part B
Please check future EDI alerts for additional 4010a1 carrier information.
The following broadcast will go out to all ProxyMed Florida customers on February 27th, 2004. This problem affects NDCMedisoft customers.
FL MEDICARE BROADCAST
Payer: Florida Medicare
Payer ID: 00118
Subject: Invalid Group Practice Number
Dates Affected: 2/2/2004 - 2/13/2004
Problems were experienced when processing Florida Medicare claims during the above dates. Some claims were incorrectly formatted resulting in invalid group practice numbers being sent to the payer. These claims rejected at the payer with the error:
MA112 - Missing/incomplete/invalid practice information
The ProxyMed systems have been corrected. Since these errors were not returned to ProxyMed, but rather to the provider on their EOBs, ProxyMed is unable to isolate these claims for resubmission. ProxyMed asks that submitters receiving this error (MA112) on their EOBs to please resubmit the affected claims.
We apologize for the inconvenience this may have caused you.
Thank you,
ProxyMed
NJ & PA
MEDICARE BROADCAST
Due to a system error, some claims for New Jersey & Pennsylvania Medicare
were rejected by the payer. This affected claims submitted to ProxyMed from
January 23, 2004 thru Feb 12, 2004. If you received the error message:
LOOP: 2310D SEG: N3 ERROR: MISSING FACILITY ADDRESS INFO
You need not resubmit your claims. ProxyMed has corrected this error and
the claims how now been resubmitted.
We apologize for the inconvenience this may have caused you.
Friday, February 13, 2004
Railroad Medicare ANSI in Production
Railroad Medicare is now in production for ANSI 4010A1 and the agreement has
been updated on the carrier agreeement map.
Blue Cross and Blue Shield of South Carolina
Trailblazer Health Enterprises has just published the following alert. At this
time, it is believed that providers will not need to resubmit the affected
claims. More information will be available soon.
#######################################################################
On Feb. 12, 2004, Blue Cross and Blue Shield of South Carolina experienced
a major hardware problem in their data center. This has resulted in a
delay in processing of all TrailBlazer's claim and payment activities, as
well as all Electronic Data Interchange (EDI) operations.
TrailBlazer anticipates the problem being resolved as timely as possible.
We will update this information as soon as it becomes available. Please
visit the TrailBlazer Web site for the latest information. We apologize
for any inconvenience this may cause.
Source: http://www.trailblazerhealth.com/notices.asp?action=detail&id=2032
GHI Medicare and NY Empire
ProxyMed is currently in testing with both of these Medicare carriers and we
anticipate approval in early March. In addition, ProxyMed is contacting both GHI
Medicare and NY Empire to ensure proper communication regarding the valid
submitter numbers under testing is being communicated to customers.
Florida & Connecticut Alert
Due to a coding system problem in the Medicare carrier system, claims submitted
for anesthesia services for CPT code range 00520 through 00539, processed from
December 23, 2003 through February 1, 2004, have been incorrectly denied as
investigational services. As of February 2, 2004, the Medicare carrier system
has been corrected and claims submitted for these anesthesia services will be
processed correctly.
No Action Required of Providers
Providers with incorrectly denied claims due to this issue do not need to take
any action. Medicare is performing adjustments immediately to correct the error
on all affected claims.
This problem affects both ANSI and NSF submitters, including both ProxyMed,
and direct module customers.
Source:
http://www.connecticutmedicare.com/provider/content/provider/special/CT-FLB-Anes-Denials-020304.pdf
Michigan BCBS & Medicaid Providers
Due to communications errors, claims received during the above dates experienced
formatting and distribution delays to the payers. These problems have been
corrected. Claims are now being sent to the respective payers. We apologize for
any inconvenience this may have caused.
---ProxyMed Inc.
Tuesday, February 10, 2004
Florida & Connecticut Alert
Due to a coding system problem in the Medicare carrier system, claims submitted
for anesthesia services for CPT code range 00520 through 00539, processed from
December 23, 2003 through February 1, 2004, have been incorrectly denied as
investigational services.
As of February 2, 2004, the Medicare carrier system has been corrected and
claims submitted for these anesthesia services will be processed correctly.
No Action Required of Providers
Providers who have claims incorrectly denied because of this issue do not need
to take any action. Medicare is performing adjustments immediately to correct
the error on all the affected claims.
This problem affects both ANSI and NSF submitters, including both ProxyMed,
and direct module customers.
Source:
http://www.connecticutmedicare.com/provider/content/provider/special/CT-FLB-Anes-Denials-020304.pdf
Michigan BCBS & Medicaid Providers
Due to communications errors, claims received during the above dates experienced
delays in being formatted and sent to the payers. These problems have been
corrected and the claims are now being sent to the respective payers. We
apologize for any inconvenience this may have caused.
ProxyMed Inc.
EDI Alert - New Jersey & Pennsylvania Medicare
New Jersey and Pennsylvania Medicare providers may be experiencing difficulties with electronic claims sent through the ProxyMed clearinghouse. We have just learned that the clearinghouse needs to complete additional 4010a1 testing for the following specialties: chiropractic, physical/occupational therapy, podiatry, and anesthesia. This affects both existing EDI providers as well as brand-new enrollees. Any claims sent for these specialties are being treated as test claims. They are not being forwarded into the claims processing system and will NOT be paid. Please ask any customers who file these sorts of claims to hold back on their billing temporarily. We expect to have an estimated time of completion for specialty testing very soon. We will send you another EDI Alert as soon as more information is available.
Florida Medicare Forwarding to FCSO
Florida Medicare Part B claims sent through ProxyMed are now being forwarded to FCSO in the ANSI 837 4010a1 format.
We are also seeing a much higher front-end rejection rate on the Medicare claims. So far, these errors appear to be customer data-entry issues due to stricter HIPAA edits. Please review the following error messages and recommended solutions:
DA002 MISSING/INVALID PAYOR ORGANIZATION ID - Look at the Policy 2 information. Get out your Medigap list and get ready to make some changes to the insurance carrier list. If you do not have a current Medigap list, you can get one from http://www.floridamedicare.com/provider/html/mainPage.asp.
1) In the case of NDCMedisoft, if the carrier is not on the list, the
Crossover box on Policy 2 of the case should NOT be checked.
2) If the carrier is on the Medigap list, the Crossover box must be
checked AND the 5-character Medigap ID must be entered in the EMC Extra
1/Medigap field of the secondary insurance carrier (EMC Codes tab).
The key here is that if you check the Crossover box, the EMC Extra 1/Medigap field CANNOT be blank.
DA002 MISSING/INVALID INSURED DATE OF BIRTH - The DA0 02 indicates that the policy which is causing the reject is the Secondary insurance. You will need to go to the Policy 2 tab of the case, click on the Policyholder, and then edit that person's date of birth. It is missing or invalid.