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Production Alerts

Title Submitters Affected Description
EDISS Connect Functionality Unavailable - Resolved 11/20/2020 For All Submitters EDISS Connect is down. EDISS is working to resolve.
EDISS Gateway Processing Issue - Resolved 11/20/2020 For All Submitters EDI is currently experiencing an issue with the EDI gateway. Trading Partners are not able to upload transactions or download. EDISS is working to resolve and apologizes for the inconvenience.
Iowa Medicaid Remittance Advice Delivery Delay - Resolved 11/18/2020 For All Iowa Medicaid Submitters A subset of Iowa Medicaid submitters may not have received their 835 Remittance Advice for 11/18/2020. EDISS is working to correct the issue and will provide and update once completed.
Iowa Medicaid Web Portal Eligibility - Resolved 11/16/2020 For All Iowa Medicaid Submitters Iowa Medicaid Web Portal users may only have access to check eligibility under a generic NPI at this time and claims status may not be available. We are working to resolve this issue and apologize for the inconvenience.
Iowa Medicaid Intermittent Connectivity - Resolved 11/16/2020 For All Iowa Medicaid Submitters EDISS is experiencing intermittent connectivity issues with Iowa Medicaid batch and real-time 200 series transactions. We apologize for any inconvenience.

Production Alert Archives

 

What's New

Top Ten Medicare Edits
For All Medicare Submitters

EDISS has created a listing of the top ten Medicare Part A and Medicare Part B edits. This information can be used by submitters to avoid common claim rejections. The Top Ten Medicare Edits will be updated quarterly and can be found on the Reports tab or at Top Ten Medicare Edits.

 

Noridian Custom Edits (NCE) to Begin October 4, 2020
For All Medicare Submitters

 

As previously educated, Noridian Custom Edits (NCE) integration is complete and will go live October 4, 2020.

 

NCE will populate in the STC elements of the 277CA with distinct code sets that can be cross referenced to the NCE Spreadsheet. To assist submitters' NCE review, Noridian established an edit spreadsheet at http://www.edissweb.com/cgp/reports/. This listing will increase as new edits are created and rolled out.

 

NCE will be reported in the 2200D STC and 2220D STC segments. The edit message will be in STC12. An example is included below:

 

STC*A3:23:41**U*********SMARTEDIT PATTERN 17198 PER MEDICARE GUIDELINES USE OF MODIFIER RH IS NOT TYPICAL FOR PROCEDURE CODE A0394.~

 

NCE enhance claims editing for both providers and payers and integrate with existing claims acknowledgement reporting (277CA) on 837 electronic claim submissions.

 

NCE allow Noridian to do the following:

 

  • Help identify problematic or “certain to deny” claims prior to Noridian claims processing
  • Alert providers of errors and potential claim processing issues around medical necessity, non-covered services, missing modifiers, and other clinical editing
  • Deliver timely and clear notifications of how to fix claim errors
  • Save administrative time tied to claim resubmissions
  • Improve transparency of claim editing and claims processing

 

ISA13 Requirement for Claim Submission Calls
For All Submitters

 

To provide the most efficient customer service possible for our Submitter community, EDISS will be implementing a change to what information is required when calling for claim submission assistance. Effective 8/1/2020, EDISS will require the ISA13 (Interchange Control Number) element from the inbound file for questions regarding claim submissions. This will specifically be required for Submitters who send more than 500 inbound files per day or in cases where the inbound file is not able to be located.

 

Providing this information ensures that EDISS reviews the correct file. Callers who do not have this may be asked to call back once they have obtained the ISA13 element.

 

A message from Noridian on COVID-19 and business continuity

 

Noridian Healthcare Solutions, LLC remains committed to its role in supporting essential functions for the Medicare FFS and Medicaid programs during the COVID-19 pandemic. Last week we moved 900 employees to temporary work from home. With nearly half of our employee base telecommuting already, we were very prepared for that move. Our process was organized, controlled, and phased to provide for continuity of business operations and the safety of our employees. Today 99 percent of our employees are work-from-home. Each of our office locations is closed, and access to those is restricted to a handful of employees with an approved business need. Those employees are operating under CDC recommended social distancing. We will continue to perform our work with quality and care.

 


 

 

 

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