JUNE NEWSLETTER

Printable verison

Palmetto J1 Transition Update – Get your Applications in now!

IThe offices here at S&A have been very busy lately. Following immediately at the heels of the NPI compliance changes on May 23rd, is another major change for our clients in CA, Nevada, and Hawaii. As S&A has over 200 clients in southern California alone, you can imagine this change is something we take very seriously.
In the very unlikely event that you have not heard what is going on, and you submit claims to Medicare part B in these areas, here is the cliff notes version.

• Palmetto GBA won the contract for Medicare part B in the afore mentioned states
• All electronic submitters MUST transition to the new system sometime AFTER June 1st, 2008, but before 9/2/08 for CA, and before 8/4/08 for Hawaii or Nevada.
• The format for claims, and the number you must dial to send claims to will be changing
• The EDI support staff will be changing as well
• Electronic Submitters MUST fill out one edi enrollment form for each billing entity, and one edi enrollment application for each provider. This is done mainly to make sure Palmetto has the most current contact information.

As long time certified vendors with NHIC, S&A was told that we did not need to test. There is an old adage that says “measure twice, cut once”, and we believe very strongly that before releasing the changes necessary for this transition, we should test. As a result, S&A has gone through the additional steps to obtain a submitter ID and test passwords for the new system, so we can ensure the roll out of the new update to you with the changes for Palmetto will go as smoothly as possible.

But all of that is putting the cart before the horse. Before we can get you transitioned to the new carrier, we must implore you to fill out and send in those enrollment forms. There are two different forms which need to be filled out.

The J1 EDI Application Form must be filled out by each submitter. You can download and fill in this form via our web site by clicking here:

J1 EDI Enrollment Application

There have been some questions about the middle section of page 3. Please make sure your page 3 looks like the following:

Each provider must fill out a J1 EDI Enrollment Form. As a courtesy, we have provided them on our web site, and they are available by clicking here:

J1 EDI Agreement Form

Please ensure that you fill these out as quickly as possible. Experience tells us that those who wait until the last moment will experience the longest delays in processing, which could mean a delay in your Medicare reimbursements.

Also, you will want to keep an eye out for our next newsletter, as we will announce once we have completed testing with Palmetto, and when you can start to submit to the new intermediary.

Blue Cross of CA now wants to be called Anthem…more changes coming for California

Who says it never rains in CA? When it comes to changes hitting the pacific coast, it not only rains, it pours. Blue Cross of CA has changed their name to Anthem Blue Cross as of April 1st, 2008. This name change brings with it changes to the ANSI claim files we are sending. The bad news is that you will need to transition as well. The good news is that S&A has already completed testing for the new carrier, and will be rolling out another free update patch allowing you to send to the new carrier. We anticipate rolling out these changes with Validator 5.14.0, which will also contain the necessary changes for the Palmetto J1 transition.

For right now submitters are encouraged to do nothing different. Blue Cross is currently busy transitioning Institutional claim types (UB04). Once they have completed that, they will be in contact with you and let you know how to proceed.