Highmark Medicare Services has become aware of DDE access issues for some of our NJ Part A Providers. Based on our analysis, it appears that some DDE Provider Access records were not moved from the Riverbend NJ A region to the new Highmark Medicare Services NJ Part A region during cutover weekend. We are currently working with Riverbend to identify the impacted access records and we are planning to add any impacted records by close of business Friday, September 5, 2008 if not sooner. We apologize for any inconvenience.

Also, during the transition weekend, the Enterprise Data Center (EDC) deleted numerous logon IDs for New Jersey Part A FISS. Highmark Medicare Services requested these IDs to be reinstated by EDC on 9/3/2008. As a result of the reinstatement process, the impacted user IDs were reset to the default password. If you are receiving a password error when attempting to utilize your FISS DDE logon for the New Jersey Part A system, please refer to the password reset instructions and the RACF ID and Password Rules.

UPDATE: Highmark Medicare Services is continuing to work with Riverbend to determine all of the impacted records. To date, we have identified 373 access records that were not transitioned from Riverbend to Highmark Medicare Services correctly. These records will be reactivated the evening of September 5, 2008 and should be available for use starting Monday, September 8, 2008. We are continuing to review additional access records that may not have been transitioned correctly and we will make updates as appropriate. We appreciate your patience as we work through this issue.

The CDS is currently experiencing technical difficulties. This has caused some claims to pend in Status Location SB0100 which is the start of the systems cycle. The CDS is currently working to resolve the problem. We will notify you of any updates via the website and listserv. Thank you!

UPDATE: CDS has identified the cause of the incorrect claim suspensions and has applied a correction. As a result, claims have now moved out of SB0100 to the correct processing locations. This issue is now resolved. Thank you for your patience.

We are aware of a transition issue that caused some NPIs to be omitted from the NJ Part A NPI crosswalk file by Maricom (NPI Crosswalk Contractor). This problem could have been the basis for unexpected claim rejections for some of our customers. Please be assured that we have identified the root cause of the problem and are working with Maricom toward an immediate resolution. Once the problem is resolved, customers affected by this issue will be required to resubmit all rejected claims. We will publish an update as soon as possible and apologize for the inconvenience.

UPDATE: Maricom has identified 6 provider NPI records that were not correctly crosswalked during the NJ Part A transition. These records have been corrected and should be re-entered into the NJ Part A FISS system the evening of September 5, 2008. Impacted providers may resubmit their claims beginning on Monday, September 8, 2008.

ORIGINAL MESSAGE: Due to system maintenance on September 2, 2008, the X12N 835 Electronic Remittance Advice (ERA) may be delayed daily the week of September 2, 2008, to validate accuracy prior to distribution. Typically, Highmark Medicare Services expects to post these reports to your electronic mailbox on the Stratus Telecommunication Server by 8:30 AM Eastern Time, but due to this system maintenance, the delivery of these files may be delayed each day. A follow-up listserv will be sent daily when the files are available for retrieval. We apologize for any inconvenience.

Due to a technical problem at the Enterprise Data Center (EDC), the Accept/Return to Provider reports for retrieval today (09/02/08) have been delayed and are not yet available. A follow-up listserv will be sent when the reports become available. We apologize for any inconvenience this may cause.

UPDATE: On 8/27/08, CMS authorized the CWF System Maintainer to begin programming changes to cancel the Trailblazer's claims at CWF from the 7/10/08 batch cycle. It is anticipated that the cancelling of the claims at CWF should occur the weekend of 10/4/08. Once the claims are cancelled at CWF, Highmark Medicare Services will automatically initiate the adjustment of claims that incorrectly denied due to the duplicate CWF records.

ORIGINAL MESSAGE:An issue has been identified concerning certain clinical laboratory and radiology services that are incorrectly denying with Ref Remark Code N347 indicating that the service was paid by another contractor. The denials are resulting from claims that were posted to the Common Working File (CWF) from the TrailBlazer's 7/10/08 batch cycle for MD/DCMA/DE Part B claims. The CWF reply file from the posting of those claims was not entered into the first batch cycle for Highmark Medicare Services by the Enterprise Data Center. When Highmark Medicare Services resent the same claims to CWF in an attempt to repost for payment, CWF rejected the claims as having already been approved for payment by TrailBlazer. These CWF rejections resulted in incorrect claim denials. Highmark Medicare Services will identify the claims impacted by the incorrect denial and will automatically adjust the claims for proper payment. Additional information concerning the recovery process will be posted to our website when available. We apologize for any inconvenience this has caused.