JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY

Size: px
Start display at page:

Download "JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY"

Transcription

1 January 2017 Pre-Meeting Announcement The January 2017 Codes Pre-Meeting is scheduled to occur on January 9th at 3:00 pm Central/4:00 pm Eastern. Call-In Details: Please join my meeting from your computer, tablet or smartphone. You can also dial in using your phone. United States: +1 (312) Access Code: First GoToMeeting? Try a test session: Charter Within the On-Line Conference, there is a conference labeled Charter. Scans of the last known hard copy of the charter are posted. Group agrees to do work on line conference and then vote at the faceto-face meetings Go to online conference and add any comments. Working draft of the existing Enabling Document as well as the individual sections attached Codes Charter Draft.docx Standing Meeting January 29, 2017 Margaret Weiker X12 owns the code sets that are maintained through this committee. X12 Board has set up a policy about external codes ECO Task group under steering and will be chaired by Mary Kay McDaniel. This group will now be called a code maintenance group (CMG). We need to come up with a group name for this committee. There will be co-chairs not chair and vice chair. CAP 12 is the X12 policy that will be reviewed to form this group s scope, charter, etc. There will be changes coming, but we do not know what yet. Margaret would like to start the documents and then present for comments, etc. We will continue to use the web board, but if it changes, there will be JANUARY 29,

2 ample time for notification. Doreen Espinoza since this is new, do we follow current processes to create? Margaret since it is a CMG, there are processes for those. It will not be under charter in the agenda s anymore. There will be a separate thread to address. CMG has 3 options for voting allows for our current structure to be used. At this point that we stay put as the structure Margaret W. we will work with the co-chairs on the process for this CMG. It can be posted as we go along. We will be working in a small group and then ask for comments, etc. Mary Lee Stine various organizations have asked what the code set is and who is maintaining. Has it been discussed what this group will be doing? Margaret we have been responsible for CARCs, if there is another list and X12 asks us to maintain, then it would be a subset. Only thing that will really be changed is the name and ECHO is in charge of all X12 owned code sets. Sherry Wilson P&C has a big interest for an industry perspective. Would we need to work with Mary Kay and ECHO? Margaret yes. Standing Meeting January 29, 2017 Old Business Tabled items September, Designation of group codes in code description Name: Company: Pat Wijtyk TGB WG3 JANUARY 29,

3 Phone: Request Type: List Name Value: Description Explanation: Revision Claim Adjustment Reason Code Various There has been questions raised related to the group codes that are designated in code descriptions and if it is required to follow the use of the group codes specified. Information was provided that a payer is not using the group codes listed in a specific code description because they feel it is not mandated. Can an FAQ be written to clarify this requirement? Commenter: Comment: Patricia Wijtyk This is not a request for a code but help with determining how the industry uses the code descriptions and direction about the use of Group Codes. Motioner: Seconder: Discussion Pre-Meeting January 8, 2016 Pat Wijtyk WG3 has done a lot of work tightening up the code descriptions. They have gotten word that payers are saying they don t have to pay attention to it; they can do what they want. She just wants to open up dialogue. Pete Anderson the code sets are adopted under HIPAA. X12 can say this is an external code set and the definitions are defined by that entity. Bob Poiesz since payers seem to be saying it is in the Note it is not the description and not applicable. Maybe we need to submit an RFI to establish that the notes in these instances are to be followed (binding). Pat W. maybe an FAQ to address, not an RFI. Gail Kocher and Pete A. - agree in an FAQ. Merri-Lee Stine in looking at CARC 16 the majority of the description is the note. Right now if you were trying to display as educational, this is the only piece that indicates what to do with the claim. This note describes how to use the code. Pat W. maybe this should be a bigger discussion on what to do with the notes. Deb Strickland NOTE was not used with Use with group code Merri-Lee S. we still need to draft an FAQ. Pat W. will be glad to organize discussion on drafting the FAQ. She will send to Bob P., Merri-Lee and Deb S. January 24, 2016 JANUARY 29,

4 Merri-Lee had discussion in pre-meeting and had a small group draft. It has been drafted, but Merri-Lee S. has not been able to review. This is being currently being worked. Pam Grosze overview of where it is going the question being posed. Do we have to do everything that is there? Recommendation there are some CARCs that use usage and others that use notes. Merri-LeeS. will put the FAQ out on the online conference for everyone to review before it is published on the site. Keep an eye on it and encourages everyone to review. Merri-Lee S. - Tabled for now as they work on the FAQ Not a code request. Pre-Meeting May 13, 2016 Merri-Lee - Pat W. asking to defer. Pat - WG3 will discuss at standing meeting in June. Meeting June 4, 2016 Pat W. made motion to table Gail Kocher seconded. Pre-Meeting August 25, 2016 Merri-Lee S. this item was tabled in last meeting Pat W. deferring again. Have started working on it but not ready. September 25, 2016 Pat Wjtyk made a Motion to approve wording for an FAQ that is related to the full description of every code. The wording was sent after the conference was closed. Gail how lengthy is the FAQ? Without knowing how involved the FAQ is she is uncomfortable voting on this. Merri-Lee: It was not posted to the conference so folks were not able to view it. She questioned the urgency to get this through with a vote today? Paw W: Replied: there isn t a requirement to have it done today, but there are payers that are not using the codes correctly today. It would allow the incorrect usage of codes for an extended period of time. Gail: Is concerned that at the pre-meeting it was deferred and she believes it needs to remain deferred. Merri-Lee: After the pre-meeting the FAQ was finished and sent only to the committee Chair, Vice Chair and Secretary. Merri-Lee took a straw poll to see if the item should remain deferred or possibly have an interim meeting. Possibly to get the writing out to the committee and before the end of the meeting get folks to review the document. Pat: withdrew a motion to approve and leave status as deferred. Wednesday, September 28, :17 AM JANUARY 29,

5 Per the discussion at the September Committee meeting, this item should be discussed in January: From: Patricia Wijtyk Sent: Friday, September 23, :15 PM To: Stine, Merri-Lee; Debra Strickland; Tina Greene Subject: Fw: Codes Committee FAQ Hi, I will be making a motion to accept this FAQ and the additional work on the CARCs (revise 'note' to 'usage') at the meeting on Sunday. Wanted to give you the wording in case there is a way to display this in the room. If not then we'll have to read it. Thanks, Pat mobile: FAQ question: What parts of the code lists does the committee consider required to be followed in order to comply with the code list usage? FAQ Response: Various codes include not just a description of the code value, but also usage, notes or parenthetical statements or guidance for additional information. The committee intends that users comply with the meaning and instructions imparted by all aspects of the code lists. Examples: - When a Claim Adjustment Reason Code (CARC) includes the statement "At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)", then usage of the code without also including a Remittance Advice Remark Code that is not an "Alert" at the appropriate level associated with the CARC does not comply with the code list. - When a CARC includes the statement "Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.", senders should consider including the policy information and receivers should look to that information for additional guidance. - When a CARC includes the statement "(Use Only Group code PR)", usage of the CARC with a Claim Adjustment Group Code other than PR does not comply with the code list. - When a Claim Status Reason Code includes "Usage: This code requires use of an Entity Code.", usage of the code without including an Entity Code within JANUARY 29,

6 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 the same Health Care Claim Status element does not comply with the code list. - When a Claim Status Category Code includes "(Note: A Claim Status Code identifying the type of information requested, must be reported)", usage of an appropriate additional status code is required. TO DO along with this FAQ: All CARCs need to be revised to replace the word 'Note' with 'Usage' 1) Codes WITH Healthcare Policy statement: 4,5,6,7,8,9,10,11,12,16,40,49,50,51,54,55,56,58,59,61,96,97,107,108,152, 167,170,171,172,179,183,184,185,222,231,240,269,B7,B8,B15 2) Codes with other notes: 45,90,133,192,219,229,232,262,263,264,265,266, P2, P4, P6, P8, P12, P13, P14, P21, P22, P23 Pre-Meeting January 9, 2016 Margaret W - Are there any questions to the examples WG3 has provided? Hearing none and assuming there will not be any issues at the face to face meeting. Gail K. has not had a chance to look at it again, but if she finds anything she will let the co-chairs know. Standing Meeting 1/29/17 Pat Wijtyk worked on wording and examples in WG3. Motion to approve the FAQ as worded, from Note to Usage. Seconded Sue Thompson Discussion: None. VOTE RESULTS - NUMBER OF: YES 15 NO 0_ ABSTAIN_1 Passed: Yes FAQ approved and to replace Note with Usage. Failed: Tabled: Assigned Code: Definition: New Business New items since the last meeting. JANUARY 29,

7 1 Correct Name on STC E0 Name: Company: Aggie Dorio Aetna Phone: Request Type: List Name Value: Description Explanation: Revision Health Care Service Type E0 - Allied Behavioral Analysis Therapy Change Allied to Applied In reviewing the STCs it looks like The STC should be Applied Behavioral Health not Allied Behavioral Health. Asking to have it changed to Applied Commenter: Comment: Motioner: Seconder: JANUARY 29,

8 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Discussion: Pre-Meeting January 9, 2016 Margaret W. correct the description. Any concerns or questions? None. Merri-Lee S. did we happen to look back at the minutes to see why it was allied and not applied? Aggie Dorio they didn t research to find why it was submitted that way, but looked at other and it was applied. Merri-Lee is going to look back to see how it was submitted. Gail K. if it was submitted as allied, we can t just change it. Merri-Lee the E0 was part of the initial load of service type codes to the code committee, but it was not part of the She hasn t found why it was part of the initial load. It would have to be there to include E0. It was not in the previous eligibility transaction. The codes were brought in in Margaret W. Bruce can you look back at 4010 or 5010? Gail K. A. not in underline standard in 2008 or Pete A. E series are part of the newer ones. Gail K. the workgroup would have to check their minutes from when the initial work was done. Standing Meeting January 29, 2017 Motion to approve Bruce B. Gail K. seconded. VOTE RESULTS - NUMBER OF: YES_17 NO 0 ABSTAIN_0 Passed: Yes Failed: Tabled: Assigned Code: Definition: 2 Review of the Service Type Code List Name: Margaret Weiker JANUARY 29,

9 Discussion: X12N/TGB/WG1 has completed review of the Health Care Service Type Code List. The WG is asking for review and feedback. Since the updated, reformatted code list must be available for the 270/271 TR3 review, please provide any feedback by EOD, December 1st. STC Cleanup w RX broken outspreadsh Having received no comments, the code list has been sent to support@x12. Pre-Meeting January 9, 2016 Margaret W. there are some questions and some discrepancies included in this spreadsheet. Nancy Spector Looks like under the tab all STCs it looks like there are items waiting on feedback. Are these going to be finalized before it is put forward to approve. Kathy her understanding is that all the questions were resolved and Aggie sent a final spreadsheet. Aggie D. there were some questions that there was no feedback so she left it in so everyone could see them. If there are no comments then those questions will most likely be removed. She left it in case anyone wanted to give them feedback. Nancy S. wasn t sure how many people had actually looked at it and reviewed. Aggie D. Margaret put it out and asked for feedback. There was feedback from numerous workgroups and code committee membership. Standing Meeting January 29, 2017 Margaret - WGs wanted to separate the list for the codes that only apply to those workgroups use. The spreadsheet has been posted for the committee to look at. No comments were received. X12 looked at it and asked what the intent was. The intent of the list is to constrain the use of codes to only a specific sub set for each transaction as applicable. There was an alternative idea to create a spreadsheet identifying how to implement. Why not take the list and go through and identify which codes apply to certain transactions and it remains one list. This way, it can be pointed to as reference. The WGs would maintain the list for their transaction and the CMG would maintain the entire list. This group will still maintain the master but the wgs that are impacted by the list maintain their specific list. Margaret asks for everyone to think about it and let Margaret and Stacy know and they can work with X12. JANUARY 29,

10 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Aggie D. the data fields that were asked for from their wg, will they still be available? Will the definitions still go in it? Margaret yes Margaret basically all we are doing is taking the master and constraining it. The suggestion was to make it an element note. She displayed an example. Donna Campbell likes the note. Has a process concern if it is shot down in the CMG what does the wg do? Is there any auto approved. We would all have to agree on the usage rules, but the wgs will then figure out if they want it? Margaret this group will need to discuss Remove a code? Margaret there would be a request come in and in the pre-meeting it is asked that they come to the pre-meeting to discuss. The time between the pre-meeting and the standing meeting the wg can discuss. It will work much like it does today. Pete A. likes the concept. Should we define what an implementation sub set rather than transaction Luann understands that the master set will not have the definitions but the subsets will. Code A is used by WG1 and W10 but they don t agree on the definition. That would put the definition more at the subset level than the main level. There are some codes that WG10 says we do use that code value, but WG1 uses it for benefits and WG10 doesn t do benefits. Her concern is more around having the definition at the main. Mary Kay if the ECHO committee comes up with something. Luann WG10 does not typically put definitions on the codes and WG1 does. Donna C. to Luann s comment she thought that it was said that the definitions would be in the master and trickle down. Where there are shared codes those are carved out and identified in the master. Stop and Start dates, there could be a start and end date in the master, but the wg may have a need for something different. That needs to be considered. Margaret and Deb agree. Debbi M. if there is a code that has different definitions for different transactions, it should be two different codes. Thinks we need to do the dates at the subset level. Mike C. has anyone talked to the translator companies to see? Margaret W. this is for healthcare services Sherry Wilson - If there was a list that was new and codes needed to be added would the P&C go directly to Mary Kay? VOTE RESULTS - NUMBER OF: YES NO ABSTAIN Passed: JANUARY 29,

11 Failed: Tabled: Assigned Code: Definition: 3 Need Service Type Code for Colonoscopy Name: Elizabeth Templeton Company: Florida Blue Phone: 904/ Request Type: List Name Elizabeth.Templeton2@floridablue.com New Health Care Service Type Value: Description Explanation: Colonoscopy We provide colonoscopy benefits for both 'routine' and 'diagnostic' colonoscopies, yet there are no existing service types congruent with a colonoscopy procedure. Existing routine service types: Routine Exam, Routine (Preventive) Dental, and Routine Physical. Existing diagnostic service types: Diagnostic X-Ray, Diagnostic Lab, and Diagnostic Medical. Due to the awkward fit of colonoscopy into existing service types (in addition to the associated tiered complexities specific to this procedure), our plan must convey (and clarify) benefits through costly manual processes. We are requesting a Service Type code be created for Colonoscopy so that benefit information can be conveyed electronically. Commenter: Comment: Motioner: Seconder: JANUARY 29,

12 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Discussion Pre-Meeting January 9, 2016 Elizabeth? 15 codes that they would like to convey. They would like an overall service type for colonoscopy. Chuck? a service type in and of itself would make it easier to identify the variety. Kathy - Unless all payers can identify the service type code the same, there won t be a standard. Unless there is something in the CPT code that will make it specific. Word of caution if they are benefited differently, you will end up with variations and will come back as procedure code exception. Chuck with all the varieties Gail K. understands that unless everything has the same benefit that rolls up you are still going to have to provide the procedure code to benefit. Kathy not necessarily the procedure itself, but may be cross procedures that take a deductible, etc. if it isn t all rolled up to the colonoscopy. Gail a service type can have multiple procedures. Requests that Elizabeth work to clarify before face to face meeting. Standing Meeting January 29, 2017 Submitter has withdrawn VOTE RESULTS - NUMBER OF: YES NO ABSTAIN Passed: Failed: Withdrawn Tabled: Assigned Code: Definition: 4 consistent use of the term real-time Name: Karen Shutt Company: Highmark Phone: karen.shutt@highmark.com JANUARY 29,

13 Request Type: List Name Value: Description Explanation: Revision Health Care Claim Status 485 and others More information available than can be returned in real time mode. Narrow your current search criteria. Per X12's development handbook, all documents should use the term 'real-time'. For consistency, please modify the terms 'real time' in the following Claim Status codes to 'real-time'. 485 More information available than can be returned in real time mode. Narrow your current search criteria. 685 Claim could not complete adjudication in real time. Claim will continue processing in a batch mode. Do not resubmit. 690 Multiple claims or estimate requests cannot be processed in real time. 691 Multiple claim status requests cannot be processed in real time. Commenter: Comment: Motioner: Seconder: JANUARY 29,

14 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Discussion Pre-Meeting January 9, 2016 Karen S. have comments on the guides that real-time is all over the place. Some are real time and others real-time. Merri-Lee S. suggests that the publisher make the change across the board. Gail K. - agrees. Karen S. that would be fine. The next agenda item (#5) is the same. Some times when we give things to the publisher they don t always turn out how they really wanted them. She is only working on the claim status codes. She didn t look on any other code lists. Merri-Lee her point was to have the publisher look across all code descriptions. Karen S. will the publisher have enough time to look at all of them and make the right determinations of how they should be written? Gail K. even though these codes are owned by x12 they are still an external code source. Karen S. the handbook indicates it should be real-time. Margaret W. motion will be for publisher to update across all guides. Standing Meeting January 29, 2017 Karen S. makes motion to approve changes to 485, 685, 690, 691 and to review all code lists. Pat W. seconded. This is for Item #4 and #5 changing from real time to Real-Time VOTE RESULTS - NUMBER OF: YES_17 NO 0 ABSTAIN_0 Passed: Yes also item # 5. Codes 485, 685, 690 and 691 change real time to real-time (all lower case) Failed: Tabled: Assigned Code: Definition: 5 JANUARY 29,

15 consistent use of the term Real-time Name: Karen Shutt Company: Highmark Phone: Request Type: Revision List Name Health Care Claim Status Value: 494, 667 Description Explanation: Real-Time requests not supported by the information holder, resubmit as batch request Per X12's development handbook, all documents should use the term 'real-time'. For consistency, please modify the terms 'Real-Time' in the following Claim Status codes to 'Real-time'. 494 Real-Time requests not supported by the information holder, resubmit as batch request 667 Real-Time requests not supported by the information holder, do not resubmit Commenter: Comment: Motioner: Seconder: JANUARY 29,

16 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Discussion Pre-Meeting January 9, 2016 Karen S. this is a verbiage change request. Margaret W. any questions? Kathy huge deal for dental. Not familiar with how it is being used. Prior authorization means that you have a treatment plan and it is estimated and fee is guaranteed for 30, 45 days (whatever it may be). The other is pretreatment, the estimate is what could be done realtime and say this is what we will likely pay. Karen assuming the payer will know what they are allowed to do. This is all around real-time. She imagines that in the dental world that prior auths aren t in real-time, etc. Karen the payer wouldn t use this code if it doesn t apply. ***adjudicated with item 4*** VOTE RESULTS - NUMBER OF: YES NO ABSTAIN Passed: Yes with item #4. CARC 494 and 697 should be changed from Real-Time to Real-time (lowercase on time) Failed: Tabled: Assigned Code: Definition: 6 Use of real-time and clarification of predetermination/estimation Name: Karen Shutt Company: Highmark Phone: Request Type: List Name karen.shutt@highmark.com Revision Health Care Claim Status Value: 687 Description Claim estimation cannot be completed in real time. Do not resubmit. JANUARY 29,

17 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Explanation: Commenter: Comment: Per X12's development handbook, all documents should use the term 'real-time'. Also, in the claim status guides predetermination and estimation are used as synonyms with respect to this real-time function and there is a spelling error in the current description. For consistency and clarification purposes, modify the description on code 687 to: Claim predetermination/estimation could not be completed in real time. Do not resubmit. Karen Shutt oops! :) I meant: Claim predetermination/estimation could not be completed in real-time. Do not resubmit. Motioner: Seconder: Discussion Pre-Meeting January 9, 2016 Karen motion to approve as stated Claim predetermination/estimation could not be completed in real-time. Do not resubmit. Pat W. seconded. VOTE RESULTS - NUMBER OF: YES 17 NO _0 ABSTAIN 0_ Passed: Yes 687 modified to Claim predetermination/estimation could not be completed in real-time. Do not resubmit. Failed: Tabled: Assigned Code: Definition: 7 Attachment info needs to be sent to third party for the payer to be able to process/pay the claim - new CARC needed Name: Company: Meg Kutz Anthem, Inc Phone: Margaret.Kutz@anthem.com JANUARY 29,

18 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Request Type: List Name New Claim Adjustment Reason Code Value: Description Explanation: New code to read : "An attachment/other documentation is required to adjudicate this claim/service. Please submit the necessary information to the third party administrator/review organization for consideration. Once that information is received the claim will be adjusted if applicable. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance< Advice Remark Code that is not an ALERT)." There is currently not a CARC to indicate for the provider to send documentation/information to a third party instead of submitting to the payer. We have two new business conditions that have this situation. The first is where we want the provider to send an itemized bill directly to third party administrator. The second is where we want the provider to send medical records directly to a third party review organization. In both instances we do process/pay and send the remittance however the third party needs information directly to support review for payment allowance/approval. We do not want this information coming directly to us. Providers should be aware of this however in some cases they need a reminder or the third party may not have received the info therefor we can't process the claim. CARC 95 would also not be clear to the providers. Commenter: Comment: Motioner: Seconder: Discussion Pre-Meeting January 9, 2016 Meg K. after workgroup discussion, this will be withdrawn and will request a RARC instead. Standing Meeting January 29, 2016 Withdrawn by submitter VOTE RESULTS - NUMBER OF: YES NO ABSTAIN Passed: JANUARY 29,

19 Failed: Tabled: Assigned Code: Definition: 8 New CARC for submit to pharmacy Name: Meg Kutz Company: Anthem, Inc Phone: Request Type: List Name margaret.kutz@anthem.com New Claim Adjustment Reason Code Value: Description Explanation: New CARC message Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's Pharmacy plan for further consideration. Similar to CARC 270 (submitted to medical but should be submitted to Dental), there are no clear denial CARC's when we as a medical payer receive a claim where the claim should have been sent to pharmacy plan for benefit application. Please create a new CARC to support a new code to deny to submit to pharmacy for processing. CARC 109 is not clear to just state wrong payer. We need the provider to understand this is not a benefit under Medical and it should be handled under pharmacy. Commenter: Comment: Motioner: Seconder: JANUARY 29,

20 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Discussion Pre-Meeting January 9, 2016 Meg K. have business conditions where need a 270 like CARC that when it is submitted to medical, it says should be submitted to pharmacy. Pam G. WG3 supports this request. Nancy S. wouldn t corrected priority payer field be use?. Meg K. explained that with this request it will point the provider in a better direction and reduce phone calls. Standing Meeting January 29, 2017 Sue T. motion to approve, Pat W. seconded. VOTE RESULTS - NUMBER OF: YES 16 NO _0 ABSTAIN_0 Passed: Yes New code is 280 Failed: Tabled: Assigned Code: 280 Definition: Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's Pharmacy plan for further consideration. 9 Home health care nursing Name: Company: Carissa Bak IDORS Phone: Request Type: List Name Bakcarissa@gmail.com New Health Care Service Type Value: Description Explanation: I am an Lpn providing home healthcare and need a code for fpi number See description Commenter: JANUARY 29,

21 Qu JANUARY 2017 MEETING SEATTLE WA SUNDAY JANUARY 29 Comment: Motioner: Seconder: Discussion Pre-Meeting January 9, 2016 Gail K. she believes there needs to be an understanding of taxonomy codes. She thinks that Carissa may have gone to the wrong place to ask about a taxonomy code. Bruce B. not enough information here to have a discussion. Deb Strickland to reach out to Carissa. Standing Meeting January 29, 2017 Deb contacted but has not received a response. Margaret need a motion Pat W. motion to disapprove. Seconded Pete A. VOTE RESULTS - NUMBER OF: YES_16 NO _0 ABSTAIN_1 Passed: Failed: Yes Tabled: Assigned Code: Definition: JANUARY 29,

June 2018 Meeting Announcement

June 2018 Meeting Announcement June 2018 Meeting Announcement The June 2018 Code Maintenance Committee meeting will be held in Jacksonville, FL on Sunday, June 3 at the Hyatt Regency Jacksonville Riverfront This is the same hotel where

More information

Group Trimester Meeting Minutes X12N TG2 WG5 Healthcare Claim Status September 26-29, 2005

Group Trimester Meeting Minutes X12N TG2 WG5 Healthcare Claim Status September 26-29, 2005 Group Trimester Meeting Minutes X12N TG2 WG5 Healthcare Claim Status September 26-29, 2005 ASC X12N/TG2/WG5/2005-34 Chair(s) Name Company Term End Date Phone Email Tapan Shah WebMD February 2006 (615)

More information

Group Minutes X12N TGX WGXX 835 Claim Payment Workgroup Feb 6, 2006 Seattle Washington

Group Minutes X12N TGX WGXX 835 Claim Payment Workgroup Feb 6, 2006 Seattle Washington Group Minutes X12N TGX WGXX 835 Claim Payment Workgroup Feb 6, 2006 Seattle Washington ASC X12N/TG2/WG3/2006-7 Chair(s) Name Company Term End Date Phone Email Pat Wijtyk HDX Feb 2007 Ph: 610-219-1825 Patricia.wijtyk@

More information

Title NPI enumeration/subpart standardized reporting Issue ID 1

Title NPI enumeration/subpart standardized reporting Issue ID 1 Title NPI enumeration/subpart standardized reporting Issue ID 1 5010 837 transactions enforce the intent of the NPI final rule. Providers must use the same enumeration strategy regardless of the health

More information

ASC X12 Clearinghouse Caucus

ASC X12 Clearinghouse Caucus ASC X12 Clearinghouse Caucus January 23, 2018 AGENDA 1. Welcome and Introduction - Joe Bell, Board Chair, Cooperative Exchange and Senior Program Manager, esolutions Inc. 2. ASC X12N Update - Stacey Barber,

More information

Group Leadership Chair Name Company Term End Date Phone Jamie Mosteller Cerner Summer

Group Leadership Chair Name Company Term End Date Phone  Jamie Mosteller Cerner Summer ASC 12N TGB WG2 SepOct Group Minutes 12N TGB/WG2 Billing and Encounter Information September - October Refer to Scheduled s Table for Call in Information Group Leadership Chair Name Company Term End Date

More information

Group Minutes X12N TGB WG10 Healthcare Services Review Jan Feb

Group Minutes X12N TGB WG10 Healthcare Services Review Jan Feb Group Minutes X12N TGB WG10 Healthcare Services Review Jan Feb 2014 1-626-677- Group Leadership Chair Name Company Term End Date Phone Email Bruce Bellefeuille Aetna Inc. October 2014 870-879- bellefeuillebr@aetna.com

More information

Group Minutes X12N TGB WG10 Healthcare Services Review Mar Apr

Group Minutes X12N TGB WG10 Healthcare Services Review Mar Apr Group Minutes X12N TGB WG10 Healthcare Services Review Mar Apr 2014 1-626-677- Group Leadership Chair Name Company Term End Date Phone Email Bruce Bellefeuille Aetna Inc. October 2014 870-879- bellefeuillebr@aetna.com

More information

Group Minutes X12N TG2 WG20 Transaction Acknowledgement January 24 29, 2010

Group Minutes X12N TG2 WG20 Transaction Acknowledgement January 24 29, 2010 Group Minutes X12N TG2 WG20 Transaction Acknowledgement January 24 29, 2010 ASC-X12N/TG2/WG20 2010-07 Chair(s) Name Company Term End Date Phone Email V Rajasekaran Highmark Jan 2012 (412) 544-1963 Valveeman.Rajasekaran

More information

Pennsylvania PROMISe Companion Guide

Pennsylvania PROMISe Companion Guide Pennsylvania Companion Guide Unsolicited 277 Claim Response Version 5010 September 2010 Version 1 Pennsylvania PROMISe Unsolicited 277 Claim Companion Guide This page intentionally left blank. September

More information

Group Minutes X12N TGC WG4 Technical Design June 5 June 9, 2016 Addison, TX

Group Minutes X12N TGC WG4 Technical Design June 5 June 9, 2016 Addison, TX Group Minutes X12N TGC WG4 Technical Design June 5 June 9, 2016 Addison, TX ASC X12N TGC WG4 2016-28 Group Leadership Chair Name Company Term End Date Becky Kimmick State Farm October 2016 Tim Pearson

More information

X12 Clearinghouse Caucus. June 6, :00-6:15pm Hyatt Regency San Antonio Rio Grande East / Center

X12 Clearinghouse Caucus. June 6, :00-6:15pm Hyatt Regency San Antonio Rio Grande East / Center X12 Clearinghouse Caucus June 6, 2017-5:00-6:15pm Hyatt Regency San Antonio Rio Grande East / Center Clearinghouse Caucus Sponsors Overview of Cooperative Exchange (CE) 24 Clearinghouse Member Companies

More information

NHS Education for Scotland Portal https://www.portal.scot.nhs.uk Dental Audit: A user guide from application to completion

NHS Education for Scotland Portal https://www.portal.scot.nhs.uk Dental Audit: A user guide from application to completion Dental Audit: A user guide from application to completion 1. Audit Guidance 2. New Application: Getting Started 3. New Application: The Audit Application Form 4. New Application: Submitting Your Application

More information

CORE Voluntary Certification: Certification from the Testing Vendor s Perspective. February 18, :00 3:00pm ET

CORE Voluntary Certification: Certification from the Testing Vendor s Perspective. February 18, :00 3:00pm ET CORE Voluntary Certification: Certification from the Testing Vendor s Perspective February 18, 2015 2:00 3:00pm ET Participating in Today s Session Download a copy of today s presentation on the CAQH.org

More information

Cabinet for Health and Family Services Department for Medicaid Services

Cabinet for Health and Family Services Department for Medicaid Services KyHealth Choices 277 Health Care Payer Unsolicited Claim Status (ASC X12N 277) Companion Guide Version 2.3 Version 003070 Cabinet for Health and Family Services Department for Medicaid Services August

More information

Published by Affiliated Computer Services, Inc. for the Alaska Department of Health & Social Services. Alaska Medical Assistance Newsletter

Published by Affiliated Computer Services, Inc. for the Alaska Department of Health & Social Services. Alaska Medical Assistance Newsletter Published by for the Alaska Department of Health & Social Services April 2009 Location: 1835 S. Bragaw St., Suite 200 Anchorage, AK 99508-3469 New Location on the Web at: http://medicaidalaska.com Phone

More information

Response to CMS. WEDI Attachment Forum Questions. August 9th Attachment Standard

Response to CMS. WEDI Attachment Forum Questions. August 9th Attachment Standard Response to CMS WEDI Attachment Forum Questions August 9th 2016 Attachment Standard August 25, 2016 Cooperative Exchange National Association of Clearinghouses 28 Clearinghouse member companies Represent

More information

Board Minutes for CoDA World Board Conference Call September 10, 2016

Board Minutes for CoDA World Board Conference Call September 10, 2016 1 P a g e Board Minutes for CoDA World Board Conference Call September 10, 2016 The Board of Trustees met on Sunday, September 10th by teleconference. Members in attendance included: Gerald B, Mary I.,

More information

Meritain Connect User Manual. for Employees. 1 Meritain Connect User Guide for Employees

Meritain Connect User Manual. for Employees. 1 Meritain Connect User Guide for Employees Meritain Connect User Manual for Employees 1 Meritain Connect User Guide for Employees Contents Introduction... 4 Accessing Meritain Connect... 5 Logging In... 5 Forgot Password... 6 Registration Process...

More information

Product Backlog Document Template and Example

Product Backlog Document Template and Example Product Backlog Document Template and Example Introduction 1. Client Information (Name(s), Business, Location, contact information) 2. Team Information Team Member Names (contact information) 3. Project

More information

X12 Clearinghouse Caucus. January 31, :00-6:30 pm Sheraton Seattle Hotel / Metropolitan B

X12 Clearinghouse Caucus. January 31, :00-6:30 pm Sheraton Seattle Hotel / Metropolitan B X12 Clearinghouse Caucus January 31, 2017-5:00-6:30 pm Sheraton Seattle Hotel / Metropolitan B Clearinghouse Caucus Sponsors Clearinghouse Caucus - ASC X12 Standing Meeting January 31, 2017-5:00-6:15pm

More information

Provider Portal Handbook

Provider Portal Handbook Provider Portal Handbook WELCOME! Welcome to AlphaMCS, a next generation Managed Care System designed specifically to meet the needs of Managed Care Organizations and the behavioral healthcare providers

More information

276/277 Health Care Claim Status Request/ Response Real-Time. Section 1 276/277 Claim Status Request/Response: Basic Instructions

276/277 Health Care Claim Status Request/ Response Real-Time. Section 1 276/277 Claim Status Request/Response: Basic Instructions Companion Document 276/277 276/277 Health Care Claim Status Request/ Response Real-Time This companion document is for informational purposes only to describe certain aspects and expectations regarding

More information

Disclaimer This presentation may be recorded. This presentation presents a sampling of best practices and overviews, generalities, and some laws.

Disclaimer This presentation may be recorded. This presentation presents a sampling of best practices and overviews, generalities, and some laws. Disclaimer This presentation may be recorded. This presentation presents a sampling of best practices and overviews, generalities, and some laws. This should not be used as legal advice. Itentive recognizes

More information

Alameda Alliance for Health

Alameda Alliance for Health Alameda Alliance for Health HIPAA Transaction Standard Companion Guide Refers to the Implementation Guides Based on ASC X12 version 005010 CORE v5010 Companion Guide October 2015 October 2015 005010 Version

More information

QuickClaim Guide Group Health Cooperative of Eau Claire GHC13009

QuickClaim Guide Group Health Cooperative of Eau Claire GHC13009 QuickClaim Guide Administered by: Group Health Cooperative of Eau Claire 2503 North Hillcrest Parkway Altoona, WI 54720 715.552.4300 or 888.203.7770 group-health.com 2013 Group Health Cooperative of Eau

More information

Here s how this whole external IRB thing works: A handbook for external IRB submissions

Here s how this whole external IRB thing works: A handbook for external IRB submissions Here s how this whole external IRB thing works: A handbook for external IRB submissions For all communication relating to external IRBs, call 414-219-7744 or email CentralIRB.Office@aurora.org. External

More information

Samples of Features and Feature Stories CSc 190

Samples of Features and Feature Stories CSc 190 Samples of Features and Feature Stories CSc 190 The following un-prioritized Product Backlog contains the user stories for the thirteen Features that were written to describe the initial functionality

More information

Your mymeritain Personalized Member Website

Your mymeritain Personalized Member Website Your mymeritain Personalized Member Website 2008 Meritain Health, Inc. Last Updated 5.23.2008 Your mymeritain Member Website The mymeritain Member Website offers Members a user-friendly web experience,

More information

HIPAA--The Medicare Experience September, Kathy Simmons Technical Advisor OIS/Division of Data Interchange Standards

HIPAA--The Medicare Experience September, Kathy Simmons Technical Advisor OIS/Division of Data Interchange Standards HIPAA--The Medicare Experience September, 2002 Kathy Simmons Technical Advisor OIS/Division of Data Interchange Standards Most of these comments are limited to the Medicare fee-for-service program. Managed

More information

epaces - Claim Status Inquiry and Response

epaces - Claim Status Inquiry and Response Version 2/Revision 12 Page 1 of 7 Overview The Claim Status Inquiry function allows the User to inquire about the status of claims currently in the NYS Medicaid s adjudication process. The Claim Status

More information

Provider Secure Portal User Manual

Provider Secure Portal User Manual Provider Secure Portal User Manual Copyright 2011 Centene Corporation. All rights reserved. Operational Training 2 August 2011 Table of Contents Provider Secure Portal... 5 Registration... 6 Provider -

More information

Health Care Eligibility Benefit Inquiry and Response (270/271)

Health Care Eligibility Benefit Inquiry and Response (270/271) X12 Standards for Electronic Data Interchange Technical Report Type 3 Health Care Eligibility Benefit Inquiry and Response (270/271) Change Log : 005010-007030 JULY 2018 Intellectual Property X12 holds

More information

Frequently Asked Questions (FAQs) Relating to the SNIA s New IP Policy v4

Frequently Asked Questions (FAQs) Relating to the SNIA s New IP Policy v4 Frequently Asked Questions (FAQs) Relating to the SNIA s New IP Policy v4 In September of 2015, the SNIA Board of Directors voted to approve an updated version of the SNIA Intellectual Property Policy

More information

Good afternoon, everyone. Thanks for joining us today. My name is Paloma Costa and I m the Program Manager of Outreach for the Rural Health Care

Good afternoon, everyone. Thanks for joining us today. My name is Paloma Costa and I m the Program Manager of Outreach for the Rural Health Care Good afternoon, everyone. Thanks for joining us today. My name is Paloma Costa and I m the Program Manager of Outreach for the Rural Health Care program. And I m joined by Carolyn McCornac, also Program

More information

Project Plan: TNI Standard Implementation

Project Plan: TNI Standard Implementation Project Plan: TNI Standard Document: ProjectPlan-NewTNIStandard-11-28-10-v11 # (Include of Review and Action Items) 1 02/12/10 2 01/27/10 QAM Template Subcommittee QS Expert Committee QAM Template Update

More information

ANSI ASC X12N 837 Healthcare Claim (Version X222A1-June 2010) Professional Companion Guide

ANSI ASC X12N 837 Healthcare Claim (Version X222A1-June 2010) Professional Companion Guide ANSI ASC X12N 837 Healthcare Claim (Version 005010X222A1-June 2010) Pruitt Health Premier Missouri Medicare Select Signature Advantage September 2015 TABLE OF CONTENTS AT A GLANCE II CHAPTER 1: INTRODUCTION

More information

Manufacturer Webinar: New Application Portal

Manufacturer Webinar: New Application Portal Manufacturer Webinar: New Application Portal The webinar will begin in 15 minutes at 2 PM Phone: (631) 992-3221 Access Code and Audio Pin shown after joining the webinar Manufacturer Webinar: New Application

More information

Kareo Claim Rejection Troubleshooting Guide January 2012

Kareo Claim Rejection Troubleshooting Guide January 2012 Kareo Claim Rejection Troubleshooting Guide January 2012 Kareo Rejection Troubleshooting Guide January 2012 1 Contents About Claim Rejections... 1 Correcting Claim Rejections... 2 Kareo Internal Validation

More information

220 Burnham Street South Windsor, CT Vox Fax OREGON MEDICAID DENTAL ELECTRONIC CLAIMS ENROLLMENT REGISTRATION

220 Burnham Street South Windsor, CT Vox Fax OREGON MEDICAID DENTAL ELECTRONIC CLAIMS ENROLLMENT REGISTRATION OREGON MEDICAID DENTAL ELECTRONIC CLAIMS ENROLLMENT REGISTRATION PAYER ID NUMBER CKOR1 SPECIAL NOTES Change Healthcare Dental signature is required. EDI packets must be mailed to Change Healthcare Dental

More information

Chapter01.fm Page 1 Monday, August 23, :52 PM. Part I of Change. The Mechanics. of Change

Chapter01.fm Page 1 Monday, August 23, :52 PM. Part I of Change. The Mechanics. of Change Chapter01.fm Page 1 Monday, August 23, 2004 1:52 PM Part I The Mechanics of Change The Mechanics of Change Chapter01.fm Page 2 Monday, August 23, 2004 1:52 PM Chapter01.fm Page 3 Monday, August 23, 2004

More information

2014 HCPCS Annual Update

2014 HCPCS Annual Update 2014 HCPCS Annual Update Information posted December 31, 2013 Note: This article applies to claims submitted to TMHP for processing. For claims processed by a managed care organization (MCO), providers

More information

Standard Companion Guide. Refers to the Implementation Guide Based on X12 Version X212 Health Care Claim Status Request and Response (276/277)

Standard Companion Guide. Refers to the Implementation Guide Based on X12 Version X212 Health Care Claim Status Request and Response (276/277) Standard Companion Guide Refers to the Implementation Guide Based on X12 Version 005010X212 Health Care Claim Status Request and Response (276/277) Companion Guide Version Number 4.0 June 12, 2018 Change

More information

Automated Information System AIS telephone user guide

Automated Information System AIS telephone user guide Automated Information System AIS telephone user guide May 2007 Department of Human Services Division of Medical Assistance Programs 500 Summer St NE, E 44 Salem, OR 97301-1077 1-800-527-5772 Contents I.

More information

4010/5010 Transition: FAQs from Ask the Experts Webinars (Updated 2/15/12)

4010/5010 Transition: FAQs from Ask the Experts Webinars (Updated 2/15/12) 4010/5010 Transition: FAQs from Ask the Experts Webinars (Updated 2/15/12) Question: We are coming across clients who are avoiding upgrading their practice management software because they say their third-party

More information

IACA Discussion List. About the IACA Discussion List. Guidelines, use and subscription management

IACA Discussion List. About the IACA Discussion List. Guidelines, use and subscription management IACA Discussion List Guidelines, use and subscription management About the IACA Discussion List The IACA discussion list (IACA List) is a free resource for all active IACA members. This resource allows

More information

Tim moves to accept, Chris Z seconds. No objections or comments.

Tim moves to accept, Chris Z seconds. No objections or comments. Minutes for PKCS 11 TC weekly concall 5-Feb-2014 1 Opening remarks (co-chairs) 2 Roll call taken by Bob Griffin. Quorum achieved. 3 Review / approval of the agenda Proposed Agenda: 1 Opening remarks (co-chairs)

More information

XML Task Group TG1 Transportation Subcommittee (X12I) Monday, 1 June, 2009 Cincinnati, OH. 3 Disapproved with comment.

XML Task Group TG1 Transportation Subcommittee (X12I) Monday, 1 June, 2009 Cincinnati, OH. 3 Disapproved with comment. XML Task Group TG1 Transportation Subcommittee (X12I) Monday, 1 June, 2009 Cincinnati, OH ASC X12I/TG1/2009-24 MEETING OPEN X12I/TG1-XML met on Monday, 1 June at about 13:30 EDT. The task group chair,

More information

IEEE P1564 Voltage Sag Indices Task Force Meeting

IEEE P1564 Voltage Sag Indices Task Force Meeting 100 Va Vb Vc Voltage (%) 50 0-50 -100-2 0 2 4 6 8 10 12 Time (c) IEEE P1564 Voltage Sag Indices Task Force Meeting Daniel Sabin Electrotek Concepts, Inc. d.sabin@ieee.org 23 July 2013 Vancouver, British

More information

Claims Attachments and HIPAA

Claims Attachments and HIPAA Claims Attachments and HIPAA The Fifth National HIPAA Summit Maria Ward PricewaterhouseCoopers, LLP Co Chair, HL7 ASIG 11/01/02 1 About your presenter Maria Ward PricewaterhouseCoopers, LLP Healthcare

More information

Medicare Advantage Provider Resource Guide

Medicare Advantage Provider Resource Guide Medicare Advantage Provider Resource Guide Thank you for being a star member of our provider team. WellCare Health Plans, Inc., (WellCare) understands that having access to the right tools can help you

More information

2011 Annual Ryan White HIV/AIDS Program Regional Data Training 9/27/2013

2011 Annual Ryan White HIV/AIDS Program Regional Data Training 9/27/2013 Hi, welcome to How to Use the Tools in the RSR web system. I am Elisa Peet from SAIC. Both Debbie Isenberg and I will be doing this session today. I will be talking through the first part addressing the

More information

Provider Portal Handbook

Provider Portal Handbook Provider Portal Handbook WELCOME! Welcome to AlphaMCS, a next generation Managed Care System designed specifically to meet the needs of Managed Care Organizations and the behavioral healthcare providers

More information

WEDI Acknowledgement Recommendations

WEDI Acknowledgement Recommendations Acknowledgement Recommendations For ASC X12N Implementation Guides, Interchange Level through Conformance Checking Version 4.0 July 2008 Enclosure 2 Workgroup for Electronic Data Interchange 12020 Sunrise

More information

CONTENTS. SETUP SECURITY ENHANCEMENTS Existing User New User (Enrolled by Employer or Self)... 18

CONTENTS. SETUP SECURITY ENHANCEMENTS Existing User New User (Enrolled by Employer or Self)... 18 FSA EMPLOYEE WEBSITE GUIDE CONTENTS BROWSER COMPATIBILITY... 2 ONLINE ENROLLMENT... 3 Online Enrollment Process... 3 Online Enrollment Option for Existing Employees... 11 REGISTERING YOUR ACCOUNT FOR ONLINE

More information

2012 Adgenda. Office Solutions. Genius Healthcare. Compliance Plans Tech Talk ICD-10 Best Office Practices Tips & Tricks EHR 5010 EDI Reports dt to et

2012 Adgenda. Office Solutions. Genius Healthcare. Compliance Plans Tech Talk ICD-10 Best Office Practices Tips & Tricks EHR 5010 EDI Reports dt to et Genius Healthcare Office Solutions The 2012 Seminar 2012 Adgenda Compliance Plans Tech Talk ICD-10 Best Office Practices Tips & Tricks EHR 5010 EDI Reports dt to et Genius Solutions, Inc. 7177 Miller Dr.

More information

HIPAA Transaction Standard Companion Guide. Refers to the Implementation Guides Based on ASC X12 version CORE v5010 Companion Guide

HIPAA Transaction Standard Companion Guide. Refers to the Implementation Guides Based on ASC X12 version CORE v5010 Companion Guide Gold Coast Health Plan CORE Companion Guide 270-271 HIPAA Transaction Standard Companion Guide Refers to the Implementation Guides Based on ASC X12 version 005010 CORE v5010 Companion Guide August 2018

More information

835 Health Care Claim Payment and Remittance Advice Companion Guide X091A1

835 Health Care Claim Payment and Remittance Advice Companion Guide X091A1 835 Health Care Claim Payment and Remittance Advice Companion Guide 004010 X091A1 Version 1.3 March 1, 2008 1-March-2008 TABLE OF CONTENTS 1 Introduction... 1 1.1 Purpose... 1 2 Transmission and Data Retrieval

More information

Welcome to today s Webcast. Thank you so much for joining us today!

Welcome to today s Webcast. Thank you so much for joining us today! Welcome to today s Webcast. Thank you so much for joining us today! My name is Michael Costa. I m a member of the DART Team, one of several groups engaged by HAB to provide training and technical assistance

More information

Group Minutes X12N TGB Full June 6, 2016 Addison, TX

Group Minutes X12N TGB Full June 6, 2016 Addison, TX Group Minutes X12N TGB Full June 6, 2016 Addison, TX ASC X12N TGB 2016-28 Group Leadership Chair Name Company Term End Date Phone Email Gloria Davis Medicalistics January 2016 404-467-1500 gdavis@medicalistics.com

More information

Phase IV CAQH CORE Operating Rules Set Approved September 2015

Phase IV CAQH CORE Operating Rules Set Approved September 2015 Phase IV CAQH CORE Operating Rules Set Approved September 2015 Phase IV CAQH CORE 450 Health Care Claim (837) Infrastructure Rule v4.0.0...2 Phase IV CAQH CORE 452 Health Care Services Review - Request

More information

Amazing Reminders User Guide

Amazing Reminders User Guide Amazing Reminders User Guide Contents Amazing Reminders Overview... 2 Installing Amazing Reminders... 3 Version 9.1 and higher... 3 Version 7.1.3 to Version 9.0... 4 Reminders Settings... 9 Reminders Timeframe

More information

Administrative Services of Kansas (ASK)

Administrative Services of Kansas (ASK) Administrative Services of Kansas (ASK) HIPAA 276/277 005010X212 Standard Companion Guide Refers to the Implementation Guides Based on ASC X12 version 005010 January 2016 1 Disclosure Statement This document

More information

User Manual CHAPTER 2. Claims Tab (for Part B Providers) Originated July 31, 2012 Revised June 3, Copyright, CGS Administrators, LLC.

User Manual CHAPTER 2. Claims Tab (for Part B Providers) Originated July 31, 2012 Revised June 3, Copyright, CGS Administrators, LLC. mycgs User Manual CHAPTER 2 Originated July 31, 2012 Revised June 3, 2015 2015 Copyright, CGS Administrators, LLC. Table of Contents 3 Accessing Detailed Claim Information 3 Viewing Detailed Claim Information

More information

Cancer Waiting Times. Getting Started with Beta Testing. Beta Testing period: 01 February May Copyright 2018 NHS Digital

Cancer Waiting Times. Getting Started with Beta Testing. Beta Testing period: 01 February May Copyright 2018 NHS Digital Getting Started with Beta Testing Beta Testing period: 01 February 2018 03 May 2018 Copyright 2018 NHS Digital Document management Revision History Version Date Summary of Changes 0.1 23/03/2018 Initial

More information

Electronic Payments & Statements (EPS) Frequently Asked Questions (FAQs)

Electronic Payments & Statements (EPS) Frequently Asked Questions (FAQs) Electronic Payments & Statements (EPS) Frequently Asked Questions (FAQs) As of August 25, 2014, your PAF reimbursements can be made by direct deposit. How do I enroll for direct deposit? You can enroll

More information

SECURE PROVIDER WEB PORTAL AND ELECTRONIC CLAIMS SUBMISSION SERVICE

SECURE PROVIDER WEB PORTAL AND ELECTRONIC CLAIMS SUBMISSION SERVICE SECURE PROVIDER WEB PORTAL AND ELECTRONIC CLAIMS SUBMISSION SERVICE SECURE PROVIDER WEB PORTAL AND ELECTRONIC CLAIMS SUBMISSION SERVICE INTRODUCTION...3 COMPUTER AND INTERNET REQUIREMENTS...4 REGISTERING

More information

Infinedi, LLC. Frequently Asked Questions

Infinedi, LLC. Frequently Asked Questions Infinedi, LLC Frequently Asked Questions Who are we? Infinedi has been helping medical providers better manage their practices since 1986 by providing the finest EDI services available. Infinedi is a privately

More information

Video Services Forum Rules of Procedure

Video Services Forum Rules of Procedure Rules and procedures for compliance with the VSF IPR Policy January 17, 2017 Introduction This document is intended to assist Video Services Forum ( VSF ) chairpersons, members and staff in taking the

More information

A process in which a claim passes through a series of edits to determine proper payment liability. Transactions copied to Transaction Repository

A process in which a claim passes through a series of edits to determine proper payment liability. Transactions copied to Transaction Repository g Accredited Standards Committee (ASC) X12 A group of government and industry members chartered by ANSI to develop national electronic standards for submission to ANSI for subsequent approval and dissemination.

More information

IACA Discussion List Guidelines, Use and Subscription Management

IACA Discussion List Guidelines, Use and Subscription Management IACA Discussion List Guidelines, Use and Subscription Management Instructions... 2 Posting Guidelines... 2 Managing your Subscription... 3 Frequently Asked Questions... 4 I sent a request to iacalist@iaca.net

More information

Companion Guide Institutional Billing 837I

Companion Guide Institutional Billing 837I Companion Guide Institutional Billing 837I Release 3 X12N 837 (Version 5010A2) Healthcare Claims Submission Implementation Guide Published December 2016 Revision History Date Release Appendix name/ loop

More information

Horizon Blue Cross and Blue Shield of New Jersey

Horizon Blue Cross and Blue Shield of New Jersey Horizon Blue Cross and Blue Shield of New Jersey Companion Guide for Transaction and Communications/Connectivity Information Instructions related to Transactions based on ASC X12 Implementation Guides,

More information

Prepared by the Minnesota Administrative Uniformity Committee (AUC)

Prepared by the Minnesota Administrative Uniformity Committee (AUC) Claim and Remittance ACKNOWLEDGMENTS BEST PRACTICE Prepared by the Minnesota Administrative Uniformity Committee (AUC) This Best Practice is intended for use with the corresponding MN Uniform Companion

More information

Lesson Share TEACHER'S NOTES LESSON SHARE. ing by Olya Sergeeva. Overview. Preparation. Procedure

Lesson Share TEACHER'S NOTES LESSON SHARE.  ing by Olya Sergeeva. Overview. Preparation. Procedure Lesson Share TEACHER'S NOTES Age: Adults Level: Intermediate + Time: 1 hour 40 minutes Objective: to practise writing work-related emails Key skills: writing Materials: one copy of the worksheet per student;

More information

Office - Claims EMDEON OFFICE USER GUIDE - CLAIMS

Office - Claims EMDEON OFFICE USER GUIDE - CLAIMS Office - Claims EMDEON OFFICE USER GUIDE - CLAIMS September, 2014 CONTENTS 1 INTRODUCTION... 9 1.1 OVERVIEW... 9 1.2 IMPORT... 9 1.3 CREATE... 9 1.4 LIST... 9 1.5 SUPPLEMENT... 10 1.6 REPORTING & ANALYTICS...

More information

ACKNOWLEDGMENTS BEST PRACTICE

ACKNOWLEDGMENTS BEST PRACTICE Claim and Remittance ACKNOWLEDGMENTS BEST PRACTICE Prepared by the Minnesota Administrative Uniformity Committee (AUC) This Best Practice is intended for use with the corresponding MN Uniform Companion

More information

Frequently Asked Questions (FAQ)

Frequently Asked Questions (FAQ) What if this list did not answer my questions? 2017 SmartHealth Wellness Program Frequently Asked Questions (FAQ) 1. Call toll free at 1-855-750-8866 2. Email support@limeade.com 3. For questions about

More information

File-Mate FormMagic.com File-Mate 1500 User Guide. User Guide

File-Mate FormMagic.com File-Mate 1500 User Guide. User Guide User Guide File-Mate 1500 FormMagic.com File-Mate 1500 User Guide User Guide User Guide - Version 7.5 Chapters Application Overview 1500 Form Printing Import and Export Install and Update Registration

More information

2016 SmartHealth Wellness Program Frequently Asked Questions (FAQ)

2016 SmartHealth Wellness Program Frequently Asked Questions (FAQ) What if this list did not answer my questions? 2016 SmartHealth Wellness Program Frequently Asked Questions (FAQ) 1. Call toll free at 1-855-750-8866 2. Email support@limeade.com 3. For questions about

More information

Manual. Attendance and Vacancy Reporting. Your Child Care Management System. Last updated Sept 13, Future Blocks Page 1 of 22

Manual. Attendance and Vacancy Reporting. Your Child Care Management System. Last updated Sept 13, Future Blocks Page 1 of 22 Manual Attendance and Vacancy Reporting Your Child Care Management System Last updated Sept 13, 2011 Future Blocks Page 1 of 22 Contents Attendance... 3 Record Attendance... 4 Edit Weekly Attendance...

More information

Massage therapy user guide

Massage therapy user guide Massage therapy user guide online claims submission... convenient service, delivered through an easy-to-use secure web site http://provider.ab.bluecross.ca/health September 2013 Massage therapy provider

More information

BHA/MA/Beacon Health Options, Inc. Provider Quality Committee Meeting Minutes

BHA/MA/Beacon Health Options, Inc. Provider Quality Committee Meeting Minutes BHA/MA/Beacon Health Options, Inc. Provider Quality Committee Meeting Minutes Beacon Health Options 1099 Winterson Road, Suite 200 Linthicum, MD 21090 Friday, January 13, 2017 10:00 am to 11:30 am In attendance:

More information

[Maria Jackson Hittle] Thanks, Michael. Since the RSR was implemented in 2009, HAB has been slowing shifting its focus from data submission to data

[Maria Jackson Hittle] Thanks, Michael. Since the RSR was implemented in 2009, HAB has been slowing shifting its focus from data submission to data [Michael Costa] Welcome to today s Webcast. Thank you so much for joining us today! My name is Michael Costa. I m a member of the DART Team, one of several groups engaged by HAB to provide training and

More information

Ordering New & Refill Prescriptions Online With Costco Mail Order

Ordering New & Refill Prescriptions Online With Costco Mail Order Ordering New & Refill Prescriptions Online With Costco Mail Order Last updated: 09/2018 Register an Account Visit: pharmacy.costco.com Click Sign In/Register and then Create Account to get started on your

More information

BCBS NJ DENTAL PRE ENROLLMENT INSTRUCTIONS 22099

BCBS NJ DENTAL PRE ENROLLMENT INSTRUCTIONS 22099 BCBS NJ DENTAL PRE ENROLLMENT INSTRUCTIONS 22099 HOW LONG DOES PRE ENROLLMENT TAKE? Standard processing is 30 45 business days. WHERE SHOULD I SEND THE FORMS? The forms need to be sent to Office Ally.

More information

Administrative Services of Kansas (ASK)

Administrative Services of Kansas (ASK) Administrative Services of Kansas (ASK) HIPAA 834 005010X220A1 Health and Dental Standard Companion Guide Refers to the Implementation Guides Based on ASC X12 version 005010 Last reviewed July 2018 1 Disclosure

More information

Using Images in FF&EZ within a Citrix Environment

Using Images in FF&EZ within a Citrix Environment 1 Using Images in FF&EZ within a Citrix Environment This document explains how to add images to specifications, and covers the situation where the FF&E database is on a remote server instead of your local

More information

Draft Minutes Automation/Drive Interface (ADI) Working Group Ad Hoc Meeting T10/02-147r0 April 30, 2002 Nashua, NH 9:05 AM 6:00 PM

Draft Minutes Automation/Drive Interface (ADI) Working Group Ad Hoc Meeting T10/02-147r0 April 30, 2002 Nashua, NH 9:05 AM 6:00 PM Draft Minutes Automation/Drive Interface (ADI) Working Group Ad Hoc Meeting T10/02-147r0 April 30, 2002 Nashua, NH 9:05 AM 6:00 PM For reference, the final agenda is included: Agenda 1. Introductions:

More information

Provider User Guides

Provider User Guides Provider User Guides Table of Contents What's New... 1 Overview of Changes:... 1 User Interface Changes... 2 Data Model Changes... 2 First Time Logging In... 5 SmartCare Basics... 9 Open a Client... 13

More information

Anthem East (Connecticut, Maine, New Hampshire) HIPAA Supplemental Billing Guidelines Professional

Anthem East (Connecticut, Maine, New Hampshire) HIPAA Supplemental Billing Guidelines Professional Objectives The purpose of these guidelines is to provide billing offices with information about several significant changes and features of the HIPAA-compliant professional claims transaction (837P). These

More information

Geospatial Commons Workgroup

Geospatial Commons Workgroup Geospatial Commons Workgroup A subgroup of the MetroGIS Technical Leadership Workgroup & MnGeo Standards Committee Agenda Thursday, September 9, 2010 1:30 to 3:30 p.m. Centennial Office Building, Room

More information

Title: The impact of configuration on Alma workflows Abstract: When initially setting up Alma, many decisions bear reexamining once you ve worked

Title: The impact of configuration on Alma workflows Abstract: When initially setting up Alma, many decisions bear reexamining once you ve worked Title: The impact of configuration on Alma workflows Abstract: When initially setting up Alma, many decisions bear reexamining once you ve worked with the system. Join us for a review of highlights of

More information

User Guide for the Provider Portal

User Guide for the Provider Portal User Guide for the Provider Portal How to Register for the Portal How to Add and Delete Users to the Portal How to Change Users Passwords How to look up Member Eligibility How to look up Claims & Remittance

More information

HIPAA 276/277 Companion Guide Cardinal Innovations Prepared for Health Care Providers

HIPAA 276/277 Companion Guide Cardinal Innovations Prepared for Health Care Providers Cardinal Innovations Prepared for Health Care Providers, February 2017 Table of Contents Preface... 4 1. Transaction Instruction (TI) Introduction... 5 1.1 Scope... 5 1.2 Overview... 5 1.3 References...

More information

Commonwealth of Kentucky KY Medicaid KyHealth Net Long Term Care (LTC) Companion Guide

Commonwealth of Kentucky KY Medicaid KyHealth Net Long Term Care (LTC) Companion Guide Commonwealth of Kentucky KY Medicaid KyHealth Net Long Term Care (LTC) Companion Guide Version 3.2 March 21, 2017 Revision History Document Version Date Name Comments 1.0 04/27/2010 EDI Created. 1.1 06/8/2010

More information

DentaQuest HIPAA Transaction Standard Companion Guide

DentaQuest HIPAA Transaction Standard Companion Guide DentaQuest HIPAA Transaction Standard Companion Guide 837D 005010X224A2 Version 1.0 January 2016 January 18, 2016 1 Disclosure Statement 2015 DentaQuest, LLC. All rights reserved. This document may be

More information

Health Care Connectivity Guide

Health Care Connectivity Guide Health Care Connectivity Guide Standard Companion Guide November 2, 2015 Version 2.0 Disclosure Statement The Kansas Department of Health and Environment (KDHE) is committed to maintaining the integrity

More information

Add Your Product to Clickbank

Add Your Product to Clickbank MODULE 3 LESSON 8 Add Your Product to Clickbank 2013 Mark Bishop NicheSynergy.com 1 Niche Synergy Table of Contents Disclaimer... 2 Why use Clickbank instead of another platform?... 3 The most important

More information

TEXAS MEDICARE (TRAILBLAZERS) CHANGE FORM MR085

TEXAS MEDICARE (TRAILBLAZERS) CHANGE FORM MR085 TEXAS MEDICARE (TRAILBLAZERS) CHANGE FORM MR085 HOW LONG DOES PRE-ENROLLMENT TAKE? Standard processing time is 20 days WHAT PROVIDER NUMBERS DO I USE? Six digit Medicare legacy provider ID NPI Number WHAT

More information