Welcome to WPS J8 Implementation - EDI Lisa Cuocci, EDI Sr. Analyst Med B JoEllen Fouts, EDI Sr. Analyst Med A.

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Presentation transcript:

Welcome to WPS J8 Implementation - EDI Lisa Cuocci, EDI Sr. Analyst Med B JoEllen Fouts, EDI Sr. Analyst Med A

Slide 2 EDI Information for the J8 Implementation WPS recognizes the important role Electronic Data Interchange (EDI) plays in your business operations; WPS’s implementation goal is to minimize impacts to existing EDI submission methods; We’d like to share some important information that J8 providers should know about EDI and the J8 implementation…

Slide 3 No New Forms for EDI Needed Providers will not need to re-enroll for EDI claims submission or Electronic Remittance Advice (ERA) provided you are: Currently an NGS EDI customer using one of the Network Service Vendors (NSVs), or; Currently a WPS submitter.

Slide 4 Network Service Vendors (NSV) WPS is working with the NSV to ensure there is no disruption in service to electronic providers; Your current connectivity through an NSV will remain in place, therefore, connectivity via bulletin board system is not required; You can use your current submitter IDs for J8.

Slide 5 J8 Contract Numbers Submitters will need to change their current contract number (receiver ID) on the weekend of the specified cutover: WorkloadCurrent CodeNew J8 CodeCutover Date IN – A July 23, 2012 IN – B August 20, 2012 MI – A July 23, 2012 MI – B July 16, 2012

Slide 6 Important X Data Element Change The new contract codes (receiver ID) will need to be placed in the following data elements within your MAC J8 X claim files: ISA-08 GS B/NM1-09 (40 qualifier) 2010BB/NM1-09

Slide 7 Important X Data Element Changes The new contract codes (receiver ID) will be reported in the following data elements within your MAC J8 X Electronic Remittance Advice: ISA-06 GS A/REF02 (2U qualifier)

Slide CMS expects trading partners to transition to 5010 transactions; WPS can assist with any 5010 transition issues; Visit the WPS EDI 5010 readiness website at: Crosswalk:

Slide 9 PC-Ace Pro32 WPS also utilizes PC-Ace Pro32 as the free, Medicare supplied billing software; Different versions of PC-Ace Pro32 are used by other payers; WPS has an upgrade which will allow retention of history, beneficiary and provider data. J8 providers will need to run the upgrade on or after your cutover date in order to transition to the new Part B J8 MAC contractor codes.

Slide 10 Michigan Part B Providers Current Michigan Medicare B submitters will not need to change their current connectivity to WPS; Current Michigan B submitters will continue to use their existing WPS submitter ID.

Slide 11 EDI ACTs These Ask the Contractor Teleconferences (ACTs) are to address your EDI questions. No reservations are required. Who should attend? Providers, billing staff, vendors or clearinghouses with Medicare EDI questions calls (all times 1-2:30 pm cst): Date Dial In ID –June 14, –August 9, –October 11, –December 6,

Slide 12 Contacting EDI EDI Hotline (8-4:00, cst): ;  Reminder: when contacting EDI via , CMS prohibits the sending of Protected Health Information (PHI) over the internet. Do not include PHI in correspondence.