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What's New

BCBS Transformation and ABILITY PC-ACE
After further review of capabilities that will be offered in the Availity Portal, the decision was made to discontinue support of PC-ACE for BCBSND business. The Availity Portal will replace current PC-ACE functionality and will be provided free of charge for our BCBSND participating providers. The decision to discontinue support of PC-ACE will only impact usage for BCBSND transactions. You can continue to utilize PC-ACE software for other payers noted above.
 
The Availity Portal will allow for streamlined claims processing and remittance delivery, which will reduce the number of sources and connectivity methods that are currently performing these functions.
 
Although we feel the Availity Portal is the optimal replacement for PC-ACE users, there are a few options outside of the Availity Portal:
 
• You may consider contracting directly with ABILITY, the vendor for PC-ACE software, for continued use of PC-ACE software for BCBSND business. For more information about ABILITY, please visit their website at https://abilitynetwork.com.
• You may also consider contracting with another third-party software vendor or clearinghouse.
• For transmission of files, you could utilize Availity's web upload capability, or pursue contracting with other 3rd party vendors for connectivity support. The decision to contract directly with ABILITY or any other 3rd party vendor may incur additional costs, which will need to be discussed with the vendor you select.
 
We continue to work through the migration of EDI submitters, and will continue to work with all providers to transition by May 31st, 2018. We look forward to working with you and will make sure that this transition is a success. As always, you may also reach out to the Provider Partnership team with questions: prov.partners@bcbsnd.com.

 

Blue Cross Blue Shield of North Dakota System Upgrade
In follow-up to a letter sent to Blue Cross Blue Shield North Dakota (BCBSND) submitters in early February, BCBSND wanted to provide submitters with additional details on the Availity transition.
 
The implementation with Availity is progressing as planned. Per previous communication, BCBSND will begin migrating Electronic Data Interchange (EDI) Submitters this month, and will work with all providers to transition by May 31, 2018.
 
Availity EDI and Portal Migration
If you're a provider that submits EDI transactions through a Clearinghouse, your Clearinghouse Partner will work with Availity to migrate your EDI submissions. The great news is that Availity already works with the majority of BCBSND Clearinghouse Partners which will ensure a streamlined migration. If your Clearinghouse Partner has specific requirements that need your involvement, they will reach out to you directly.
 
For providers that work with a Billing Service or submit EDI transactions directly to BCBSND, more specific details regarding migration timeline and activities will be shared soon.
 
BCBSND looks forward to working with you and helping make sure that this transition is a success. Any questions can be directed to prov.partners@bcbsnd.com.

 

EDISS to End Support of Modem Technology
For All Direct Submitters
 
With technology and connectivity advancements through the years, modem technology has outlived its relevancy within the Healthcare industry. Noridian Healthcare Solutions (NHS) has begun its efforts to sunset support of modem technologies.
 
NHS will no longer support modem functionality after October 1st, 2018.
 
Any provider or vendor who utilizes modems for connectivity and data exchange with Noridian will need to find alternative methods for this transfer. To learn more about this effort, click here.
 
NOTE: NHS and EDISS cannot assist with making this decision for your organization. We encourage your facility to research and determine which Network Service Vendor fits with your unique needs.

 

EDISS Remittance Advice Process Change
Based on recent CMS direction involving suppression of Standard Paper Remittance Advice (SPR) outlined in Change Request (CR) 10151, EDI Support Services (EDISS) is implementing a process change for Medicare 835 Remittance Advice recipients.
 
CR10151 eliminates the issuance of SPRs to providers/suppliers who have been receiving Electronic Remittance Advice (ERA). More details around the CR can be found here: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10151.pdf.
 
Part B providers are encouraged to register for the full remittance advice option in NMP. For more information on NMP registration and functionality, please visit www.noridianmedicare.com.

Production Alerts

Claim Processing Issue – 5/15/2018 – Resolved
For All Medicare Part A and B Providers

The processing delay EDI Support Services (EDISS) experienced impacting a subset of 837 files submitted on May 11, 2018, has been resolved. 999 and 277CA reports for these files have been delivered.

Remittance Advice Delay Identified – 5/10/2018 – Resolved
For All Medicare Part A and B Providers

The remittance advice for all Medicare Part A and B lines of business for May 11, 2018, are delayed.

Processing Delay – 5/10/2018 – Resolved
For All Medicare Part A and B Submitters

EDI Support Services (EDISS) is experiencing a processing delay that is impacting all Medicare Part A and Medicare Part B inbound claim files submitted on May 10, 2018, starting at 3:00 pm (CST) to current. This is causing a delay in 277CA report delivery.

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