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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 Medicare Remittance Advice Reminder
Based on CMS direction involving suppression of Standard Paper Remittance Advice (SPR) outlined in Change Request (CR) 10151, EDI Support Services (EDISS) wants to ensure providers are aware of the following: If you are currently registered with EDI to receive the Electronic Remittance Advice (ERA) and decide to remove the option from EDISS Connect, Noridian cannot revert your remittance back to the ERA. Once the electronic option is removed from EDISS Connect, the following options will only be available for obtaining the remittance advice information:

 

Medicare Part A Providers:
Part A providers will only have the option of viewing their Remittance Advice information in the Noridian Medicare Portal (NMP), as single-line Remittance Advice only. The claim-level remittance information is also available using the Direct Data Entry (DDE) system. The only way to obtain the full remittance advice again would be to add the 835 transaction back into the EDISS Connect account.

 

Medicare Part B Providers:
Part B providers will only be able to view their full Remittance Advice in the NMP. To view a Remittance Advice in NMP, providers will need to register for the NMP full remittance advice access.
 
To learn more information about CR10151 and CMS’s approach to SPR reduction, the following link will take you to the MLN article: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10151.pdf.
 
For more information on NMP registration and functionality, please visit:
www.noridianmedicare.com.

Production Alerts

Medicare Remittance Advice Delay – 7/3/2018 – Resolved
For Medicare Part B CA, HI, and NV Submitters

The remittance advice for Medicare Part B for CA, HI, and NV for July 3, 2018, have now delivered successfully and are available for download.

Claim Processing Delay – 6/21/2018 – Resolved
For All Submitters

EDI Support Services (EDISS) experienced a processing issue that impacted a subset of files sent between June 18, 2018, at 1:00 PM (CST) through June 19, 2018, at 3:00 PM (CST). 999 and 277CA reports have now delivered. Some submitters may receive duplicate rejections on the 277CA report for these files.

Medicare Remittance Advice Delay – 6/21/2018 – Resolved
For All Medicare Part A and AK, AZ, CA, HI, MT, NV, OR, UT, and WA Medicare Part B Submitters

The remittance advice for the below Lines of Business and Regions that were delayed for June 21, 2018, have now delivered.

Medicare Part A: Medicare Part B:
JE: All Regions JE: CA, HI, NV
JF: All Regions JF: AK, AZ, MT, OR, UT and WA

 

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