Stephens & Associates is proud
to announce that our Validator Direct Electronic Claims program is
now capable of sending claims to Medi-Cal in the 837 institutional
formats. This format, which was released just before the October cutoff
for the non-compliant ANSI format that Medi-Cal WAS accepting, can
be used by Lytec users who would normally bill on the UB92 paper form.
This is the second official electronic UB92 format that Stephens &
Associates has released, with the first one being Riverbend Medicare
for rural healthcare facilities in California. Both formats can be
downloaded via an update patch for current Validator users, and those
who have either a Silver or Bronze version may utilize it for no additional
charge. The development team at Stephens & Associates plans to
develop the electronic UB92 format for THIN and AltaPoint next.
By now you may have heard
that CMS has handed down a proclamation that as of October 1st, all
Medicare intermediaries will be rejecting all claims received on paper.
Several intermediaries have sent out letters and are placing messages
on their telephone lines warning payers that they intend to reject
all paper Medicare claims received after October 1st. In these communications,
the Medicare intermediaries are saying that there are “few exceptions”
to the rule, and stress that even secondary claims sent to Medicare
(aka MSP claims) must be sent electronically, but they usually fail
to mention that one of the exceptions to this rule is any provider
with fewer than 20 employees, which of course accounts for the vast
majority of submitters.
What very few people are aware of is that the Validator is not only
capable of sending MSP claims, but has always been able to do so.
There is a catch, however. Due to some limitations in Lytec’s
abilities, you will have to answer some questions in the Validator.
While the Validator can create the file correctly for MSP claims,
it cannot pull ALL of the information Medicare requires about the
claim, such as how much did the Primary Pay, how much did you have
to write off, and why (which is called the claim adjustment reason
code). If you set the secondary insurance company type field to “Medicare
Secondary” and send that claim through the Validator, the Validator
will create the file the way it needs to be created for MSP claims,
and then ask the end-user, for each claim, the answer to those three
required questions. Your Validator dealer can likely use custom fields
to minimize or remove any of these three requirements, and you should
consider calling them for a custom setup if you plan on doing any
large volume of MSP claims.
NEIC
goes HIPAA compliant!
Although Empire BCBS of NY was very reluctant
to support the ANSI format, they did finally make the decision to
continue to support claims through Empire to NEIC in the HIPAA compliant
ANSI format. Stephens & Associates has just recently completed
testing with Empire BCBS of New York for this format. This carrier
is designed specifically for those who are currently submitting to
Empire Medicare for New York through their IVANS system, and works
very much like THIN does, in that it can be used to submit any number
of commercial payers electronically. This is available as a free download
to anyone who is submitting to Empire Medicare, and the Validator5
program. While we usually wait to release new carrier modules until
we have a new release of the Validator, the extremely short notice
of the changeover necessitated an early release. There are instructions
available in our articles section on our web site, which explain how
you can obtain this free update.
Another Great reason to Go
for the Gold!
Although Stephens & Associates’ Validator program is certified
to be HIPAA compliant in over 23 states, many of our clients do not
know that you can use the Validator to submit HIPAA compliant claims
to ANY carrier capable of receiving them. This little known feature
of our Gold Validator version allows you, in a period of just a few
minutes, to start submitting claims to any HIPAA compliant carrier
by using a simple, easy to follow wizard interface. You can use this
ability to start to submit claims directly to any carrier across the
United States, whether it is a Medicare intermediary in North Carolina,
or a local HMO in Sand Diego, CA. If you have a carrier in mind that
you would like to submit directly to, and would like to know more
about this feature, please feel free to call your friendly neighborhood
Validator dealer today!
Coming
Soon!!! On-line Demos
Look
for our upcoming online Demos of various products and service available
at Stephens and Associates.
