 |
 |
HIPAA UPDATE
- Medicaid Trading Partners Urged to Test
- Edit Help Tool Now Available
- ePACES Software is Upgraded
- Parallel Proprietary/835 Remittances
- HIPAA on the Web
Medicaid Trading Partners Urged to Test
A significant percentage of Medicaid’s trading partners have still not registered to test through EDIFECS at https://www.nyhipaadesk.com. This is a major concern as Medicaid is contemplating the development of claims processing guidelines that may affect the payment of non-HIPAA claims. It is essential that our partners successfully complete their Medicaid HIPAA testing as quickly as possible to avoid possible financial risks that may result from non-compliance. Providers that use the services of a clearinghouse or service bureau, or purchase HIPAA-compliant software from vendors, do not need to test directly with Medicaid. However, these providers need to be in constant contact with their clearinghouse, service bureau or software vendor to assure the entity they do business with is proceeding aggressively with its testing/compliance plan.
Edit Help Tool Now Available
Medicaid has developed, and posted at https://www.nyhipaadesk.com, an edit help tool for submitters of HIPAA Test and Production claims. This tool, the Edit/Error Knowledge Base, presents users with individual spreadsheets for their Test and Production Deny and Pend errors for each cycle. The spreadsheets may be downloaded or opened and submitters will be able to find their respective Tape Supply Number(s) and see the MMIS edits they failed for that particular cycle. In addition, edits displayed in blue (as a hyperlink) can be clicked and a page will be displayed describing the edit, the causes for the edit failing and a solution for correcting the problem.
To use this valuable tool just click the News & Resources tab at the top of the https://www.nyhipaadesk.com home page. On the left side of the News & Resources page click the little box with the plus sign next to the Edit/Error Knowledge Base topic. This will expand the topic. Expand the Cycle Spreadsheets topic. Next just click the cycle spreadsheets you wish to view and get the help you need to correct your Test or Production HIPAA claims. Cycle spreadsheets are posted at https://www.nyhipaadesk.com every Tuesday. New edit pages are being added based on the frequency of the edit failure, so be sure to check this facility every week.
ePACES Software is Upgraded
Computer Sciences Corporation, the Medicaid fiscal contractor, has enhanced and upgraded the popular ePACES software. ePACES is HIPAA-compliant software developed exclusively for Medicaid providers that used to submit a variety of HIPAA transactions and eligibility inquiries. ePACES is available, free of charge, to any Medicaid enrolled provider that may be searching for a HIPAA-compliant, simple to use software application. Smaller volume trading partners especially are encouraged to consider ePACES as an alternative to expensive practice management billing systems. Trading partners that are still submitting paper claims should seriously consider ePACES as the application of choice for converting to HIPAA-compliant electronic claiming. Extensive information on ePACES enrollment and user requirements at www.emedny.org, just click on the ‘HIPAA’ topic.
Parallel Proprietary/835 Remittances
Medicaid and CSC are developing a process that in the near future will allow submitters of HIPAA Test and Production claims to receive both the X12 835 and, by written request, the MMIS proprietary remittances. Currently submitters of HIPAA Test and Production claims receive the X12 835 remittance for all their approved and denied claims, but only receive proprietary remittance data for their first 25 claims. The new process will allow submitters to request that they receive the paper proprietary remittance for their entire submission. This will allow submitters to perform critical comparative analyses of their claims and will enhance the current HIPAA testing process. We anticipate that the parallel process will be in place by early June 2004. Check the https://www.nyhipaadesk.com web site regularly for developments and HIPAA-related announcements.
HIPAA on the Web - https://www.nyhipaadesk.com & www.emedny.org, for HIPAA information and technical/systems requirements.
|
|
|
|
|
