April 11, 2008

Attention Part A Pennsylvania EDI BILLERS - Reports Now Available

The following Pennsylvania files and reports for data received 04/07/08 and 04/08/08 are now available for retrieval: 277 Responses, 997 Responses, IG Edit Reports. Due to technical issues at the EDC, the following files and reports were not created on 04/08/08. However, these files and reports were created and are available for retrieval today. The files listed here are available for retrieval today and contain both 04/07/08 and 04/08/08 data: 835 ERA and Forced Balance/Out of Balance Reports, Accept Return to Provider Reports.

April 8, 2008

Attention:  PA And MD Providers

CMS has instructed FIs to hold all claims received 4/5/08 or later until recently received standard systems changes can be tested an validated. The claims are being held in Status/Location SMOPPS  with Reason Code WW001.  This is a temporary edit to suspend all claims with receipt dates greater than 04/04/08. We will notify you as soon as validation is completed and the claims are released.  Update: All payments and remittances for payments of 4/8 and 4/9 were issued today on remittances date 04/09/08.

Attention PA Part A Providers Only:

The Enterprise Data Center (EDC) has notified us that there were a number of problems when attempting to run the Batch Cycle, relating to the quarterly release installation. This has impacted several contractors under EDC. In order to bring the on-line Production up timely today, the EDC had to delay running the Batch Cycle for 04/07/08 until tonight. (04/08/08). Therefore, no payments or remittances were issued.  Update: All claims have been released with the exception of those routinely held for Pricer payment verification.
 

April 7, 2008

Attention: PA and MD Providers

Effective with the 4/7/08 cycle due to recent FISS enhancements related to NPI, the NPI will populate the provider number field on the Remittance Advice, ERA and Standard Paper Remit (SPR) when:

• There is a CCN/NPI combination on the claim
• There is a NPI only on the claim
• If there is a CCN only on the claim, the provider number field will contain the CCN

March 11, 2008

Attention Part A Pennsylvania Electronic Accept/Return-to-Provider Report Recipients

Due to a technical issue, some Accept/Return-to-Provider (RTP) Reports were not distributed electronically last Thursday, March 06, 2008 and Friday, March 7, 2008. The technical problem has been resolved and the missing reports are now available for retrieval. If you expected an Accept/RTP Report last Thursday or Friday, but did not receive it, the reports are now available.  

March 5, 2008

Attention EDI Billers: EDI Report Availability Delayed on March 6

Due to scheduled system maintenance, the availability of EDI reports will be delayed on Thursday, March 6, 2008. This includes the following EDI reports: 997 Functional Acknowledgment, IG Edit Report, Accept/Return-to-Provider (PA only), 277 Claim Status Response, Electronic Remittance Advice (ERA), and Forced Balance/Out of Balance Reports. The EDI reports are expected to be available for retrieval by noon on Thursday, March 6, 2008. Please retrieve your reports once they become available. Thank you.

February 19, 2008

Claims Summary Screen Missing Claims - Update

Highmark Medicare Services previously reported a problem where providers were unable to view claims in the Claims Summary Screen of the FISS. This problem has been corrected and the majority of claims are now viewable in the Claims Summary screen within FISS. We will continue to update you via the website and listserv as we continue to post the missing claim information.

January 28, 2008

Attention EDI Providers PA Part A EDI Claims Received on January 25, 2008

Pennsylvania Part A EDI claims received on January 25, 2008, were sent to the Enterprise Data Center; however, the claims were not entered into the processing system until January 26, 2008. These claims will reflect a January 26, 2008, receipt date. We apologize for any inconvenience this may cause.

January 23, 2008

Stratus Telecommunication Server Unavailability

Pennsylvania Part A EDI claims received on January 25, 2008, were sent to the Enterprise Data Center; however, the claims were not entered into the processing system until January 26, 2008. These claims will reflect a January 26, 2008, receipt date. We apologize for any inconvenience this may cause.

Deactivation of Reason Code 32151 in FISS For MD Providers

Highmark Medicare Services has received approval from CMS to deactivate Reason Code 32151 in FISS. This will temporarily resolve the problem that our Maryland providers are experiencing when submitting claims with a 13X type of bill (TOB), that do not have Revenue Code 36X and are changing to a 831 TOB. The claims will be recycled. Any claims in the Return to Provider (RTP) location, please correct the bill type from a 831 to the appropriate 13X TOB and F9 the claim. Thank you for your patience and cooperation as we have worked diligently to resolve this issue.

January 18, 2008

Attention MD/DC and PA Providers EMC Claim Files UPDATE

A problem was identified in the FISS where EMC claims were rejecting incorrectly with the following error message: BILLING NPI REQD. A temporary fix has been put in place and providers can now rebill the claims.

Attention MD/DC and PA Providers Claims Summary Screen Missing Claims - Update

Highmark Medicare Services previously reported a problem where providers were unable to view claims in the Claims Summary Screen of the FISS. This problem has been corrected and the majority of claims are now viewable in the Claims Summary screen within FISS. We will continue to update you via the website and listserv as we continue to post the missing claim information.

January 17, 2008

Important Update Regarding IG Edit Report

ATTENTION EDI BILLERS: The Part A IG Edit Report problem with the "BILLING NPI REQD" error message that was identified on January 10, 2008, has been corrected. The edit logic is now working as expected. Effective for EDI claims submitted after 4PM on Thursday, January 17, 2008, the following rejection will occur on the IG Edit Report for any EDI claims submitted without an NPI reported in the 2010AA-NM109 and 2010AB-NM109 billing providers fields: "BILLING NPI REQD". To avoid this rejection, please report the billing NPI in the NM109 segment of the billing provider loops immediately if you are not already doing so.

January 10, 2008

Attention MD/DC and PA Providers - EMC Claim Files Update

A problem was identified in the FISS where EMC claims were rejecting incorrectly with the following error message: BILLING NPI REQD. A temporary fix has been put in place and providers can now rebill the claims.

January 9, 2008

Attention MD/DC and PA Providers - Important Information About EMC Claim Files

EMC Claims Files received 01/07/2008 were not loaded into FISS until 01/08/2008. The receipt date on those claims will be 01/08/2008.

January 9, 2008

Attention MD/DC and PA Providers - Claims Summary Screen Missing Claims

A problem has been identified that the Claims Summary screen within FISS is not displaying the claim information. This appears to be a display problem and had been reported to Companion Data Services (CDS).  Please do not rebill the claims. We will update you via a listserv message when the problem has been corrected.

January 5, 2008

Attention Maryland Providers!  Payments and Remittances Issue (Oct)

The payments and remittances scheduled to be released with the January 1, 2008 date in some cases, may also include payments for services that were not scheduled to be released until January 8, 2008. The payment amounts are correct and no actions are required on your part. We are currently investigating the cause of the problem and will keep you informed of any additional impacts.

October 25, 2007

Attention PA Providers! FISS Alert

The Fiscal Intermediary Standard System (FISS) is currently unavailable. The Enterprise Data Center (EDC) has been notified of the problem. There is no estimated time when the system will be available. We will keep you informed of the progress made to restore access to the FISS via a listserv message.

October 11, 2007

Attention PA Providers! Duplicate Payment Issue

Highmark Medicare Services has discovered a payment issue with remittances dated September 25, 2007. Duplicate payments have been issued on this date for Pennsylvania Part A providers only. The correct payment and remittance of September 24, 2007 were duplicated within the payment and remittance date of September 25, 2007. Click here for the complete bulletin on this topic.

October 3, 2007

ERA Alert for PA Part A ERA Customers

The Pennsylvania Part A Electronic Remittance Advice (ERA) posted to your electronic mailbox on October 3, 2007, contains the same payment information as the Pennsylvania Part A ERA posted to your electronic mailbox on October 2, 2007.

The Pennsylvania Part A ERA posted to your mailbox on October 2, 2007, contains a file creation date of October 1, 2007 and a payment date of October 2, 2007. This ERA is a valid file and should be posted to your accounts receivable.

The Pennsylvania Part A ERA posted to your mailbox on October 3, 2007, contains a file creation date of October 2, 2007 and the SAME payment date of October 2, 2007. This ERA is an invalid file and should not be posted to your accounts receivable.

We are in the process of recovering the accurate ERA file from the Enterprise Data Center. We will post the corrected ERA to your mailbox for retrieval as soon as possible.

Thank you for your patience. We apologize for any inconvenience this may cause.

September 28, 2007

Attention PA Part A Providers only - ERA Alert for PA Part A ERA Customers

The Pennsylvania Part A Electronic Remittance Advice (ERA) posted to your electronic mailbox on September 27, 2007, contains the same payment information as the Pennsylvania Part A ERA posted to your electronic mailbox on September 26, 2007.

The Pennsylvania Part A ERA posted to your mailbox on September 26, 2007, contains a file creation date of September 25, 2007, and a payment date of September 26, 2007. This ERA is a valid file and should be posted to your accounts receivable.

The Pennsylvania Part A ERA posted to your mailbox on September 27, 2007, contains a file creation date of September 26, 2007, and the SAME payment date of September 26, 2007. This ERA is an invalid file and should not be posted to your accounts receivable.

We are in the process of recovering the accurate ERA file from the Enterprise Data Center. We will post the corrected ERA to your mailbox for retrieval as soon as possible.

Thank you for your patience. We apologize for any inconvenience this may cause.

September 24, 2007

Attention PA Part A Providers only - Duplicate Payment Issue

Highmark Medicare Highmark Medicare Services has discovered a payment issue with remittances dated 9/25/07. It appears that duplicate payments have been issued for PA Part A providers only. The correct payment and remittance of 9/24/07 was duplicated within the payment and remittance date of 9/25/07.  We are currently identifying the exact overpayment amount for each impacted provider and the appropriate recovery process. We will advise you of the resolution shortly. We apologize for any inconvenience this may cause you.

September 10, 2007

New RACF ID Info

Prior to September 10, 2007, PA Part A providers were advised to access the Highmark Medicare Services website and complete the online RACF ID PIN Request Form. As of September 10th, the online form is no longer available.

Any provider who previously completed the form correctly will receive their RACF ID, PIN and Temporary Password at the email address provided in the request form. Providers who did not complete the online request form will have their RACF ID, PIN and Temporary Password assigned by Highmark Medicare Services and mailed to the provider's address of record. Please ensure hardcopy notices are distributed to FISS ID holders in a timely manner.

September 4, 2007

Attention MD/DC Providers! FISS Logon Issue With New RACF IDs

Highmark Medicare Services is aware of the systems issue that is preventing providers from logging onto the Fiscal Intermediary Standard System (FISS) using their new RACF IDs. Providers are currently receiving the system error message TSS7145E. We have determined that this error is an Arkansas Data Center message resulting from not modifying your connectivity port. Ivans and VisionShare have provided helpdesk numbers to assist you in modifying your connectivity ports.

For those providers that use "IVANS" as their vendor and are encountering the error message - TSS7145E, they must contact IVANS Support Help Desk at:

• 1-800-548-2675
• Choose Option #3
• Then choose Option #2

For those providers that have "Vision Share" as their vendor and are encountering the error message - TSS7145E, they must contact the Vision Share Support Help Desk at 612-460-4310.

August 29, 2007

Attention MD/DC Providers! Reason Code 32103 Received in Error - Update

The Arkansas Data Center (ADC) has corrected the systems issue which caused claims to error with Reason Code 32103 incorrectly. Effective 09/28/07, the affected claims have now been recycled through the system for processing. Thank you for your patience in this matter.

August 23, 2007

Attention MD/DC Providers! Reason Code 32103 Received in Error

Provider record updates transmitted to the NPI crosswalk by the Arkansas Data Center (ADC) on 08/17/2007 are causing claims to receive Reason Code 32103 in error. These claims are being Returned to the Provider (RTP'd). The Arkansas Data Center and the Centers for Medicare and Medicaid Services (CMS) will be coordinating the provider record corrections. No provider action is necessary at this time. We will advise providers of the recovery process via listserv and website communication. Thank you.

August 17, 2007

Remittance problem

Due to technical difficulties within FISS, PA Part A remittances were not generated for 08/17/07. We are currently determining when those remittances can be recreated. We will send a listserv message with additional information once that determination has been made. We apologize for any inconvenience this may cause.

August 9, 2007

ATTENTION! Transition to the Enterprise Data Center (EDC) requires that additional information be on file for all HIQA/FISS RACF ID's. In order for Highmark Medicare Services to properly support your logon ID, each logon must have an assigned email address (that accurately reflects the individual user assigned to the logon ID) as well as a user-selected Personal Identification Number (PIN) that is to be used in the event that a password reset is required.

ACTION REQUIRED!

Click here to complete and submit the EDC Transition Customer Information Form. Completion of this form is required so that we may collect the necessary information to create your new FISS RACF ID.

Enterprise Data Center Transition

The Centers for Medicare & Medicaid Services (CMS) is consolidating Medicare data center operations at more than 20 facilities into four state-of-the-art Enterprise Data Centers (EDCs). The new data centers will help Medicare accommodate a growing claims volume, standardize operations, expand electronic services, bolster security, and lower costs by hundreds of millions of dollars over the next 10 years. Click here for important information regarding the EDC transition and how it impacts providers.

July 30, 2007

Immediate Offset Requests

If you called Highmark Medicare Services Immediate Offset line (1-888-291-2623) requesting immediate offset, there was trouble with the line. We lost all messages from Wednesday, July 25, 2007 through 9:00 am the morning of Friday, July 27, 2007. The line is now working. If you left a message for immediate offset on Wednesday through 9:00 am Friday, we are asking that you fax those requests into our office. We are making three fax lines available - (717) 302-3823, (717) 302-3807 and (717) 302-4273. Thank you. We apologize for any inconvenience this matter may have caused.

July 12, 2007

System Maintenance Scheduled for Sunday, July 15, 2007

System maintenance is scheduled for Sunday, July 15, 2007 from 8:00 AM - 11:00 AM. During this maintenance time, EDI billers who are using the Highmark Medicare Services LAN will not be able to conduct EDI transactions (drop off or pick up files via dial-up FTP). We apologize for any inconvenience this may cause and appreciate your cooperation.

NOTE: EDI billers using the Stratus Telecommunication Server, the new Part A EDI Front-End Platform, will not be affected and will be able to conduct EDI transactions as usual.

May 31, 2007

REASON CODE 32103

We have found in most of the recently reported instances related to Reason Code 32103 there are discrepancies related to one of the data elements below. If you are receiving 32103, we encourage you to go the NPPES webpage and verify and/or update the following data elements:
1. Legal Business Name
2. Tax ID (EIN)
3. Legacy Number - the "Other Provider ID" field must be populated with the legacy number that should be matched to the NPI.

Make sure the NPPES data is saved.

May 21, 2007

Maryland FISS Now Available

The problem which was impacting Maryland FISS Providers has been corrected. We apologize for the inconvenience. Thank you for your patience.

April 18, 2007

Alert For Maryland FISS Providers

Highmark Medicare Services has been advised that there is a problem which is impacting Maryland FISS Providers. The Arkansas Data Center has advised this is an AT&T router problem. AT&T is currently working to resolve the issue, however, there is no estimate at this time as to when it will be resolved. We will keep you posted of any additional updates. We apologize for the inconvenience. Thank you for your patience.

March 30, 2007

Problem Impacting Maryland FISS Providers

The AT&T router problem that had impacted connectivity to the Arkansas Data Center and the Maryland/DC FISS region on Friday, March 30, 2007, has been resolved. We apologize for the inconvenience.

March 30, 2007

Problem Impacting Maryland FISS Providers

Highmark Medicare Services has been advised that there is a problem which is impacting Maryland FISS Providers. The Arkansas Data Center has advised that two AT&T routers are down. AT&T is currently working to resolve the issue, however, there is no estimate at this time as to when it will be resolved. We will keep you posted of any additional updates. We apologize for the inconvenience. Thank you for your patience.

January 23, 2007

Incorrect Adjustments for CWF Unsolicited Responses

CMS will be issuing Change Request 5507 which will provide instructions to the FIs and CWF related to paying the claims that were incorrectly canceled. A Medlearn Matters article will be available shortly after the CR is released.

January 12, 2007

Incorrect Adjustments for CWF Unsolicited Responses

The Centers for Medicare and Medicaid Services has announced that the Common Working File incorrectly issued unsolicited responses related to Medicare Advantage files to contractors during December 2006. For Highmark Medicare Services contract areas, approximately 1,500 Part A Claims and 7,500 Part B Claims may have been impacted. CMS is expected to issue instructions to contactors, in the near future, providing direction on how to handle the incorrect responses and the follow up activity that will be required. Additional information will be posted as it is made available.